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Clinical Psychology Workforce Project

Division of Clinical Psychology UK

Dr Alison Longwill Chartered Clinical Psychologist Woodcote Consulting Ltd mailto:[email protected]

Tel: 0207 148 7170

Mob: 07976 745396

[email protected]

November 2015

mailto:[email protected]

DRAFT ONE Clinical Psychology Workforce Project: DCP UK CONFIDENTIAL

Dr Alison Longwill of 218 02 November 2015

Clinical Psychology Workforce Project ............................................................. 1

Division of Clinical Psychology UK ................................................................... 1

1 EXECUTIVE SUMMARY ......................................................................... 19

1.1 Aims of the Project ............................................................................ 19

1.2 Key findings ...................................................................................... 19

1.2.1 Demography ............................................................................... 19

1.2.2 Geographic distribution: equity of provision ................................ 20

1.2.3 Impact of austerity ...................................................................... 20

1.2.4 Areas and sectors of work .......................................................... 20

1.2.5 Professional membership ........................................................... 21

1.2.6 Key themes, concerns and service gaps .................................... 21

1.2.7 Areas of development ................................................................ 23

1.3 Recommendations ............................................................................ 24

2 INTRODUCTION AND OVERVIEW ........................................................ 27

3 POLICY AND PRACTICE CONTEXT ..................................................... 28

3.1 Epidemiology .................................................................................... 28

3.2 Policy Context ................................................................................... 29

3.3 “No Health without Mental Health” Strategy ...................................... 29

3.4 Closing the Gap and Parity of Esteem .............................................. 32

3.5 Better Access .................................................................................... 32

3.6 Annual Report of the Chief Medical Officer 2013 Public Mental Health Priorities: Investing in the Evidence ............................................................ 33

3.7 The Francis Report ........................................................................... 33

3.8 NHS England 5 Year Forward View .................................................. 33

3.9 Outcomes framework ........................................................................ 35

3.9.1 NHS outcomes framework ......................................................... 35

3.9.2 Public health outcomes .............................................................. 37

3.9.3 Social care outcomes ................................................................. 37



3.10 Evidence-based best practice ........................................................ 38

3.11 Influencing behaviour through public policy ................................... 38

3.12 Mental Capital and Wellbeing ........................................................ 38

3.13 Roles of Clinical Psychologists ...................................................... 41

3.13.1 Evidence-based practice ......................................................... 41

3.13.2 Range of interventions based on psychological theory and science 42

3.13.3 Competence frameworks for the delivery and supervision of Psychological Therapies.......................................................................... 43

3.13.4 Governance, risk management and quality assurance ........... 45

3.13.5 Training and Supervision ........................................................ 45

3.13.6 Research and service development and innovation ................ 45

3.13.7 Leadership Skills of Clinical Psychologists.............................. 46

3.14 Expanding areas of demand for clinical psychology ...................... 48

3.14.1 Cost-effectiveness .................................................................. 48

3.14.2 Payment by Results and Care Clusters: Psychological components of care packages ................................................................. 48

3.14.3 Clinical Health Psychology, Public Health and Prevention and Long Term Conditions ............................................................................. 49

3.14.4 Neuropsychology .................................................................... 50

3.14.5 Adult Mental Health ................................................................. 50

3.14.6 Improving Access to Psychological Therapies (IAPT) ............. 50

3.14.7 Child and Adolescent Health ................................................... 50

3.14.8 Older Adults ............................................................................ 50

3.14.9 Intellectual Disabilities ............................................................. 51

3.14.10 Forensic Clinical Psychology .................................................. 51

3.14.11 Organisational and Management ............................................ 51

3.14.12 Private, Independent and Voluntary/Third Sector ................... 51

4 METHODOLOGY .................................................................................... 52



5 HEALTH AND CARE PROFESSIONS COUNCIL DATA ........................ 53

5.1 Age and Gender breakdown of UK Clinical Psychologists ................ 53

5.2 HCPC Registered Clinical Psychologists by UK Health Authority Region ........................................................................................................ 56

5.3 Number of clinical psychologists per 100,000 population for England, Scotland, Wales and Northern Ireland ........................................................ 58

6 NHS ENGLAND: CENTRAL INFORMATION ......................................... 59

6.1 Age ................................................................................................... 59

6.2 Gender .............................................................................................. 60

6.3 Ethnicity ............................................................................................ 60

6.4 Number of clinical psychologists per HEE Region and per 100,000 population ................................................................................................... 61

6.5 Number of clinical psychologists in England by AfC pay band .......... 63

6.5.1 Workforce validation by Clinical Psychology NHS Trust Leads .. 64

6.6 Number of clinical psychologists in England by AfC pay band by Health Education England Regions ............................................................ 64

6.6.1 Health Education East Midlands................................................. 66

6.6.2 Health Education East of England .............................................. 67

6.6.3 Health Education Kent, Surrey and Sussex ............................... 69

6.6.4 Health Education North East ...................................................... 70

6.6.5 Health Education North West ..................................................... 71

6.6.6 Health Education North West London ........................................ 74

6.6.7 Health Education South London ................................................. 75

6.6.8 Health Education North Central and East London ...................... 77

6.6.9 Health Education South West .................................................... 78

6.7 Health Education Thames Valley ...................................................... 80

6.8 Health Education Wessex ................................................................. 81

6.9 Health Education West Midlands ...................................................... 82

6.10 Health Education Yorkshire and Humber: number and bandings .. 84



7 NHS SCOTLAND .................................................................................... 86

7.1 Age ................................................................................................... 86

7.2 Gender .............................................................................................. 87

7.3 Ethnicity ............................................................................................ 88

7.4 Disability ........................................................................................... 89

7.5 Regional distribution of clinical psychology staff in Scotland ............ 90

7.6 Vacancies for clinical psychology (March 2015) ............................... 92

7.7 Pay Band .......................................................................................... 93

7.8 Specialties and areas of work ........................................................... 93

7.9 Types of contract .............................................................................. 95

7.10 NHS Education for Scotland Applied Psychology Workforce training 95

7.11 Retention in NHS Scotland and attrition rates: clinical psychology trainees in Scotland .................................................................................... 96

7.12 Clinical psychology workforce supply over time: NHS Scotland (w.t.e and headcount) ................................................................................. 97

7.13 Clinical psychologists per 100,000 population: NHS Scotland....... 98

8 NHS WALES ......................................................................................... 100

8.1 Age ................................................................................................. 100

8.2 Gender ............................................................................................ 100

8.3 Ethnicity .......................................................................................... 101

8.4 Number of clinical psychologists by AfC Pay Band: Health Boards in Wales – January 2015 .............................................................................. 102

9 NHS NORTHERN IRELAND ................................................................. 105

9.1 DHSSPS data ................................................................................. 105

9.1.1 Age ........................................................................................... 105

9.1.2 Gender ..................................................................................... 106

9.1.3 Number of clinical psychologists by AfC pay band: Northern Ireland 107



9.2 Division of Clinical Psychology: Northern Ireland data .................... 108

9.2.1 Headcount and Pay Band of clinical psychologists .................. 108

9.2.2 Specialties/areas of work ......................................................... 110

9.2.3 Vacancies and types of contract............................................... 111

10 CLINICAL PSYCHOLOGY ONLINE SURVEY ................................... 111

10.1 Age .............................................................................................. 112

10.1.1 Planned age of retirement ..................................................... 114

10.2 Gender ........................................................................................ 116

10.3 Ethnicity ....................................................................................... 117

10.3.1 Ethnicity of survey respondents ............................................ 118

10.4 Employer(s) ................................................................................. 119

10.5 Salary/pay band ........................................................................... 120

10.6 Changes in Pay Band: last 2 years .............................................. 121

10.7 Type of contract ........................................................................... 122

10.7.1 Main employment contract .................................................... 122

10.7.2 Overall types of employment contracts ................................. 123

10.8 Hours of work .............................................................................. 124

10.9 Main areas of work of UK Clinical Psychologists ......................... 125

10.9.1 Estimated number and % of HCPC clinical psychologists working in various specialties and estimated norms per 100,000 UK population .............................................................................................. 127

10.9.2 Addictions ............................................................................. 131

10.9.3 Adult IAPT services ............................................................... 134

10.10 Adult Mental Health ..................................................................... 137

10.11 Child and Family .......................................................................... 139

10.12 Clinical Health Services ............................................................... 141

10.13 Commissioning ............................................................................ 143

10.14 Consultancy ................................................................................. 145



10.15 Eating Disorders .......................................................................... 147

10.16 Forensic Services ........................................................................ 150

10.17 HIV Sexual Health ....................................................................... 152

10.18 Learning Disability ....................................................................... 155

10.19 Management ................................................................................ 157

10.20 Neuropsychology ......................................................................... 159

10.21 Older Adults ................................................................................. 162

10.22 Paediatric psychology .................................................................. 165

10.23 Perinatal psychology ................................................................... 168

10.24 Primary care ................................................................................ 171

10.25 Teaching/training others .............................................................. 175

10.26 Teaching/training clinical psychologists ....................................... 178

10.27 University/higher education ......................................................... 181

10.28 Other activity ................................................................................ 184

10.29 DCP Membership ........................................................................ 187

10.30 Future Needs and Service Gaps: Clinical Psychology Views (online survey 2015) ............................................................................................. 188

10.30.1 Some narrative responses .................................................... 188

10.30.2 Emerging areas ..................................................................... 191

10.30.3 Summary of key themes ....................................................... 193

10.30.4 Clinical psychologists' view of service needs and gaps (West Midlands online survey June 2014) ....................................................... 195

10.31 Service User views ...................................................................... 197

10.32 Areas of concern ......................................................................... 198

10.33 Areas of development .................................................................. 198

11 WORKFORCE PLANNING: POPULATION NEEDS ANALYSIS ....... 199

11.1 Population trends ......................................................................... 203

11.1.1 The population is growing ..................................................... 203



11.1.2 The population is becoming more diverse............................. 203

11.1.3 More people are living alone ................................................. 203

11.1.4 Birth rate ............................................................................... 204

11.1.5 Life expectancy and healthy life expectancy are growing ..... 204

11.1.6 The population is ageing ....................................................... 204

11.1.7 Health inequalities persist ..................................................... 204

12 SUPPLY AND DEMAND MODELLING FOR CLINICAL PSYCHOLOGY 205

12.1 Centre for Workforce Intelligence: Improving workforce planning for the psychological therapies workforce ...................................................... 205

12.1.1 Key findings and recommendations from CfWI ..................... 205

12.2 Data quality: Electronic Staff Record ........................................... 208

12.2.1 Retirement ............................................................................ 208

12.2.2 Pay drift ................................................................................. 208

12.2.3 Non-NHS Workforce ............................................................. 208

12.2.4 Supply model parameters ..................................................... 208

12.3 TRAINING COMMISSIONS FOR CLINICAL PSYCHOLOGY ..... 209

12.3.1 UK Training Places for Clinical Psychology per head of population .............................................................................................. 209

12.4 DCP Workforce Model (Draft) ...................................................... 209

12.4.1 Data accuracy and collection methods ................................. 209

12.4.2 Vacancy ................................................................................ 210

12.4.3 Staff movement ..................................................................... 210

12.4.4 Draft Workforce Planning Model ........................................... 211

13 ACKNOWLEDGEMENTS .................................................................. 214

14 GLOSSARY OF TERMS .................................................................... 214

Figure 1 Mental Health Dashboard ................................................................ 31

Figure 2 NHS Outcomes Framework ............................................................. 36



Figure 3 Mental Capital and Well-being ......................................................... 40

Figure 4 Leadership skills of Clinical Psychologists ....................................... 47 Figure 5 Age and Sex Distribution of UK Clinical Psychologists ................... 54

Figure 6 HCPC Gender breakdown of clinical psychologists ......................... 54 Figure 7 Number of UK HCPC Registered Clinical Psychologists by age band ....................................................................................................................... 55 Figure 8 Percentage of HCPC UK Registered Clinical Psychologists in various age bands ...................................................................................................... 55

Figure 9 HCPC Registered UK Clinical Psychologists by Health Authority/Region ............................................................................................ 56 Figure 10 % of UK HCPC Registered Clinical Psychologists by Health Authority/Region ............................................................................................ 56 Figure 11 Number of HCPC registered UK Clinical Psychologists in England, Scotland, Wales and Northern Ireland ........................................................... 57 Figure 12 Number and percentage of UK Clinical Psychologists in England, Scotland, Wales and Northern Ireland ........................................................... 57

Figure 13 Number of Clinical Psychologists per 100,000 of UK Nations ........ 58 Figure 14 Percentage of clinical psychologists in various age bands: England NHS workforce ............................................................................................... 60 Figure 15 Ethnic breakdown of clinical psychologists in NHS workforce in England .......................................................................................................... 61 Figure 16 Estimate of number of clinical psychologists per 100,000 by Health Education England Region ............................................................................ 63 Figure 17 Distribution of clinical psychologists by Agenda for Change NHS Pay Band ....................................................................................................... 63

Figure 18 Percentage of clinical psychologists employed in various AfC Pay Bands ............................................................................................................. 64

Figure 19 Actual number of clinical psychologists (n = 19 validated returns) as % HSCIC December 2014 data ..................................................................... 64

Figure 20 Distribution of clinical psychologists in England by AfC Pay Band by Health Education Regions ............................................................................. 65

Figure 21: Number of clinical psychologist by AfC pay band: East Midlands Region ........................................................................................................... 66

Figure 22: Health Education East Midlands: no of clinical psychologists by NHS Trust ...................................................................................................... 67 Figure 23 Number of clinical psychologist by AfC pay band: Health Education East of England .............................................................................................. 67 Figure 24 Overall number of clinical psychologists by AfC pay band: Health Education England ......................................................................................... 68 Figure 25: Number of clinical psychologists by AfC pay band: Health Education Kent, Surrey and Sussex .............................................................. 69

Figure 26 Number of clinical psychologists by AfC pay band by NHS Trusts: Kent, Surrey and Sussex ............................................................................... 70 Figure 27 Number of clinical psychologists by AfC pay band Health Education North East ...................................................................................................... 70

Figure 28 Number of clinical psychologists by AfC pay band by NHS Trusts: Health Education North East .......................................................................... 71 Figure 29 Number of clinical psychologists by AfC pay band: Health Education North West ..................................................................................................... 71



Figure 30; Number of clinical psychologists by AfC pay band by NHS Trusts: North West ..................................................................................................... 73 Figure 31: Number of clinical psychologists by AfC pay band: North West London ........................................................................................................... 74 Figure 32 Number of clinical psychologists by AfC pay band by NHS Trusts: North West London ........................................................................................ 75 Figure 33: Number of clinical psychologists by AfC pay band: South London 75 Figure 34 Number of clinical psychologists by AfC pay band by NHS Trusts: South London................................................................................................. 76 Figure 35 Number of clinical psychologists by AfC pay band: North, Central and East London ............................................................................................ 77 Figure 36 Number of clinical psychologists by AfC pay band by NHS Trusts: North, Central and East London ..................................................................... 78

Figure 37 Number of clinical psychologists by AfC pay band: South West .... 78 Figure 38 Number of clinical psychologists by AfC pay band by NHS Trusts: South West .................................................................................................... 79

Figure 39 Number of clinical psychologists by AfC pay band: Thames Valley ....................................................................................................................... 80 Figure 40 Number of clinical psychologists by AfC pay band by NHS Trusts: Thames Valley ............................................................................................... 81

Figure 41 Number of clinical psychologists by AfC pay band: Wessex .......... 81 Figure 42 Number of clinical psychologists by AfC pay band by NHS Trusts: Wessex .......................................................................................................... 82 Figure 43 Number of clinical psychologists by AfC pay band: West Midlands82 Figure 44 Number of clinical psychologists by AfC pay band by NHS Trusts: West Midlands ............................................................................................... 84 Figure 45 Number of clinical psychologists by AfC pay band: Yorkshire and Humber .......................................................................................................... 84

Figure 46 Number of clinical psychologists by AfC pay band by NHS Trusts: Yorkshire and Humber ................................................................................... 85 Figure 47 Age profile of Clinical Psychologists in NHS Scotland March 2014 and March 2015 ............................................................................................. 87 Figure 48 Clinical psychology staff in Scotland by Regions (inc. Special Health Boards) .......................................................................................................... 90 Figure 49 Percentage of clinical psychologists working in various Scottish Regions (inc. Special Health Boards) ............................................................ 91

Figure 50 Percentage of clinical psychologists in various AfC pay bands: NHS Scotland ......................................................................................................... 93

Figure 51 % of clinical psychologists in Scotland employed in various specialties ...................................................................................................... 94 Figure 52 Clinical psychology w.t.e. staff employed in various areas of work in NHS Scotland: March 2014 and March 2015 ................................................. 94 Figure 53 Percentage of clinical psychology staff on permanent employment contracts in NHS Scotland: March 2015 ........................................................ 95 Figure 54 High Retention Rate of Doctorate in Clinical Psychology Trainees in NHS Scotland held over time following course completion (2003-2015) ........ 96 Figure 55 Headcount of D Clin Psych Graduates (2008-2014) employed in NHS Scotland Psychology Services by NHS Board. ...................................... 97 Figure 56 NHS Scotland Clinical Psychology Workforce: Supply over time: w.t.e. .............................................................................................................. 97



Figure 57 NHS Scotland Clinical Psychology Workforce: Supply over time: headcount. ..................................................................................................... 98 Figure 58 NHS Scotland w.t.e Clinical Psychologists per 100,000 population as at 30th June 2015. .................................................................................... 98 Figure 59 Percentage of clinical psychologists in various age bands: NHS Wales ........................................................................................................... 100 Figure 60 Ethnic breakdown of clinical psychologists in Wales ................... 102 Figure 61 Number of clinical psychologists by AfC Pay Band in Wales ....... 102

Figure 62 Number of clinical psychologists in Wales by Health Board and AfC Pay Band ..................................................................................................... 103 Figure 63 % of clinical psychologists in various pay bands: NHS\Wales January 2015 ............................................................................................... 104 Figure 64 % of clinical psychologists in various age bands: Northern Ireland: DHSSPSS data ............................................................................................ 106 Figure 65 Number of clinical psychologists by NHS Trusts: Northern Ireland: DHSSPS data .............................................................................................. 106

Figure 66 Number of clinical psychologists by NHS Trust: Northern Ireland (DHSSPS data) ............................................................................................ 107 Figure 67 Number of clinical psychologists by AfC pay band: Northern Ireland: DHSSPS data .............................................................................................. 108

Figure 68 Headcount and Pay Band of Clinical Psychologists in Northern Ireland: DCP data ........................................................................................ 110

Figure 69 Main areas of specialty of clinical psychologists in Northern Ireland ..................................................................................................................... 110 Figure 70 Main areas of work of clinical psychologists in Northern Ireland .. 111

Figure 71 Age distribution of survey respondents ........................................ 112 Figure 72Planned age of retirement of clinical psychologists (online survey) ..................................................................................................................... 114

Figure 73 Planned age of retirement: clinical psychologists over 50 years .. 116

Figure 74 Gender of survey respondents ..................................................... 117 Figure 75 Ethnicity of survey respondents ................................................... 119

Figure 76 Salary band(s) by main and subsidiary employers of clinical psychologists ............................................................................................... 120

Figure 77 Mean salary of clinical psychologists with main and subsidiary employers (pro-rata) .................................................................................... 121 Figure 78 Pay band now compared to 2 years ago...................................... 122

Figure 79 Mean hours per week with main employer ................................... 124 Figure 80 Mean hours of clinical psychologists’ hours of work per week (all employers) ................................................................................................... 124 Figure 81 Percentage of clinical psychologists working with main and subsidiary employers ................................................................................... 125

Figure 82 Number of sessions worked per specialty .................................... 127 Figure 83 Estimated no. of UK clinical psychologists per specialty .............. 129 Figure 84 Estimated percentage of UK psychologists per specialty ............. 129 Figure 85 Estimated w.t.e of UK clinical psychologists of UK population by specialty ....................................................................................................... 130 Figure 86 Estimated percentage of UK clinical psychologists working in various sectors of care ................................................................................. 130 Figure 87 Clinical psychologists areas of specialty work by sector (primary, secondary, tertiary or university ................................................................... 131



Figure 88 Estimated no. of UK clinical psychologists working with addictive difficulties by sessions per week .................................................................. 132 Figure 89 Estimated percentage of UK working with addictive difficulties by sessions per week ....................................................................................... 132 Figure 90 Estimated total clinical psychology sessions per week in addictive difficulties ..................................................................................................... 133 Figure 91 Estimated headcount and w.t.e. of UK clinical psychologists working in addictive difficulties .................................................................................. 133

Figure 92 Estimated no. of UK clinical psychologists working in adult IAPT services ........................................................................................................ 135 Figure 93 Estimated percentage of UK clinical psychologists working in adult IAPT services by sessions/week .................................................................. 135 Figure 94 Estimated total clinical psychology sessions per week in adult IAPT ..................................................................................................................... 135 Figure 95 Estimated headcount and w.t.e of UK clinical psychologists working in adult IAPT ................................................................................................ 136

Figure 96 Estimated no. of UK clinical psychologists working in adult mental health ........................................................................................................... 138 Figure 97 Estimated percentage of clinical psychologists working in adult mental health by sessions/week .................................................................. 138

Figure 98 Estimated total clinical psychology sessions per week in adult mental health ............................................................................................... 138

Figure 99 Estimated headcount and w.t.e. of UK clinical psychologists working in adult mental health ................................................................................... 139 Figure 100 Estimated no. of UK clinical psychologists working in child and family services ............................................................................................. 140 Figure 101 Estimated percentage of UK clinical psychologists working in child and family services by sessions/week ......................................................... 140

Figure 102 Estimated total no.of sessions per week in child and family services ........................................................................................................ 140 Figure 103 Estimated headcount and w.t.e. of UK clinical psychologists working in child and family services ............................................................. 141 Figure 104 Estimated no. of UK clinical psychologists working in clinical health services ........................................................................................................ 142 Figure 105 Estimated percentage of UK clinical psychologists working in clinical health services by sessions/week .................................................... 142

Figure 106 Estimated total UK clinical psychology sessions/week in clinical health services ............................................................................................. 143

Figure 107 Estimated headcount and w.t.e. of UK clinical psychologists working in clinical health psychology ........................................................... 143 Figure 108 Estimated no. of UK clinical psychologists working in commissioning ............................................................................................. 144 Figure 109 Estimated percentage of UK clinical psychologists working in commissioning by sessions/week ................................................................ 144 Figure 110 Estimated total sessions/week working in commissioning: UK clinical psychologists .................................................................................... 145 Figure 111 Estimated headcount and w.t.e of UK clinical psychologists working in commissioning ............................................................................ 145 Figure 112 Estimated no. of UK clinical psychologists working in consultancy ..................................................................................................................... 146



Figure 113 Estimated percentage of UK clinical psychologists working in consultancy by sessions/week ..................................................................... 146 Figure 114 Estimated total sessions/week in consultancy: UK clinical psychologists ............................................................................................... 147 Figure 115 Estimated headcount and w.t.e. of UK clinical psychologists working in consultancy ................................................................................. 147 Figure 116 Estimated no. of UK clinical psychologists working in eating disorders ...................................................................................................... 148

Figure 117 Estimated percentage of UK clinical psychologists in eating disorder by sessions/week ........................................................................... 148 Figure 118 Estimated total sessions/week of UK clinical psychologists working in eating disorders ........................................................................................ 149 Figure 119 Estimated headcount and w.t.e. of UK clinical psychologists working in eating disorders .......................................................................... 149 Figure 120 Estimated no. of UK clinical psychologists working in forensic services ........................................................................................................ 151

Figure 121 Estimated percentage of UK clinical psychologists working in forensic services by sessions/week ............................................................. 151 Figure 122 Estimated total no. of clinical psychology sessions/week in forensic services ........................................................................................................ 151

Figure 123 Estimated no. of UK clinical psychologists working in HIV/sexual health ........................................................................................................... 153

Figure 124 Estimated % of UK clinical psychologists working in HIV/sexual health services by sessions/week ................................................................ 154 Figure 125 Estimated total UK clinical psychology sessions/week in HIV/sexual health ......................................................................................... 154 Figure 126 Estimated headcount and w.t.e. of UK clinical psychologists working in HIV/sexual health services .......................................................... 155

Figure 127 Estimated no. of UK clinical psychologists working in learning disability ....................................................................................................... 156 Figure 128 Estimated % of UK clinical psychologists working in learning disability by sessions/week .......................................................................... 156 Figure 129 Estimated headcount and w.t.e of UK clinical psychologists working in learning disability ........................................................................ 157 Figure 130 Estimated no. of clinical psychologists working in management 158 Figure 131 Estimated % of UK clinical psychologists working in management by sessions/week ......................................................................................... 158 Figure 132 Estimated sessions/week in management ................................. 159

Figure 133 Estimated no. and w.t.e. of UK clinical psychologists working in management ................................................................................................ 159 Figure 134 No. of clinical psychologists working in neuropsychology, sessions and no. on specialist register of neuropsychologists (online survey n=4568). ..................................................................................................................... 160 Figure 135 Estimated no. of UK clinical psychologists working sessions in neuropsychology .......................................................................................... 161

Figure 136 Estimated % of UK clinical psychologists working in neuropsychology by sessions/week ............................................................. 161 Figure 137 Estimated sessions per week in neuropsychology ..................... 162 Figure 138 Estimated headcount and w.t.e. of UK clinical psychologists working in neuropsychology ......................................................................... 162



Figure 139 Estimated no. of UK clinical psychologists working in older adult services ........................................................................................................ 163 Figure 140 Estimated % of UK clinical psychologists working in older adult services by sessions/week ........................................................................... 164 Figure 141 Estimated total UK clinical psychology sessions in older adult services ........................................................................................................ 164 Figure 142 Estimated headcount and w.t.e. UK clinical psychologists working in older adult services .................................................................................. 165

Figure 143 No. of UK clinical psychologists working in paediatric services . 166 Figure 144 Estimated % of UK clinical psychologists working in paediatric services by sessions/week ........................................................................... 167 Figure 145 Estimated UK clinical psychology sessions/week in paediatric services ........................................................................................................ 167

Figure 146 Estimated headcount and w.t.e. of UK clinical psychologists working in paediatric services ...................................................................... 168

Figure 147 Estimated no. of UK clinical psychologists working in perinatal services ........................................................................................................ 169 Figure 148 Estimated % of UK clinical psychologists working in perinatal services by sessions/week ........................................................................... 169 Figure 149 No. of UK clinical psychology sessions/week in perinatal services ..................................................................................................................... 171 Figure 150 Estimated headcount and w.t.e. of UK clinical psychologists working in perinatal services ........................................................................ 171 Figure 151 Estimated no. of UK clinical psychologists working in primary care services ........................................................................................................ 173

Figure 152 Estimated % of UK clinical psychologists working in primary care by sessions/week ......................................................................................... 173

Figure 153 Estimated UK clinical psychology sessions/week in primary care ..................................................................................................................... 174

Figure 154 Estimated headcount and w.t.e. of UK clinical psychologists working in primary care ................................................................................ 174

Figure 155 Estimated no. of UK clinical psychologists working in teaching/training others ................................................................................ 175

Figure 156 Estimated % of UK clinical psychologists working in teaching/training others by sessions/week ................................................... 176 Figure 157 Estimated UK clinical psychology sessions/week in teaching/training others ................................................................................ 176 Figure 158 Estimated headcount and w.t.e UK clinical psychologists involved in teaching/training others ............................................................................ 177 Figure 159 Estimated no. of UK clinical psychologists working in teaching/training psychologists .................................................................... 179

Figure 160 Estimated % of UK clinical psychologists working in teaching/training clinical psychologists by sessions/week ........................... 180 Figure 161 Estimated no. sessions teaching psychologists/week ................ 180 Figure 162 Estimated headcount and w.t.e. UK clinical psychologists involved in teaching/training clinical psychologists ..................................................... 181 Figure 163 Estimated no. of UK clinical psychologists working sessions in university/higher education .......................................................................... 182 Figure 164 Estimated % of UK clinical psychologists working in university/higher education by sessions/week ............................................. 183



Figure 165 Estimated UK clinical psychology sessions/week in university/higher education .......................................................................... 183 Figure 166 Estimated headcount and w.t.e of UK clinical psychologists working in university/higher education ......................................................... 184 Figure 167 No of UK clinical psychologists working in "other areas" ........... 185 Figure 168 Estimated % of UK clinical psychologists working in "other areas of work" by sessions/week ............................................................................... 186 Figure 169 Estimated UK clinical psychology sessions working in "other areas of work" ........................................................................................................ 186 Figure 170 Estimated headcount and w.t.e of UK clinical psychologists working in "other areas of work" ................................................................... 186 Figure 171 Needs and Gaps: Clinical Psychologists' views ......................... 196 Figure 172 Areas of unmet clinical need: Online survey June 2014 ............ 197

Figure 173 Workforce Planning Framework: Centre for Workforce Intelligence ..................................................................................................................... 202

Figure 174 Centre For Workforce Intelligence: Big Picture Challenges ....... 203

Figure 175 UK Population trends 2012 to 2032 ........................................... 203 Figure 176 Estimate of staff movement in relation to clinical psychology posts ..................................................................................................................... 211 Figure 177 Demonstration output: Supply and Demand ............................. 213

Table 1 Public Health Outcomes .................................................................... 37

Table 2 Social Care Outcomes Framework ................................................... 37 Table 3 Number of Clinical Psychologists per 100,000 population of UK nations ........................................................................................................... 58

Table 4 Age breakdown of clinical psychologists in NHS Employment in England .......................................................................................................... 59

Table 5 Gender breakdown of clinical psychologists in NHS Employment in England .......................................................................................................... 60

Table 6 Ethnic breakdown of clinical psychologists in England (NHS employment) .................................................................................................. 60

Table 7 Number of clinical psychologists per Health Education England Region and per 100,000 population ............................................................... 62

Table 8: Number of clinical psychologists by AfC pay band by Health Education Regions ......................................................................................... 65 Table 9: Pay Band of Clinical Psychologists by NHS Trusts: Health Education East Midlands Region .................................................................................... 66 Table 10 Number of Clinical Psychologists by AfC pay band by NHS Trusts: East of England Region ................................................................................. 68 Table 11 Number of clinical psychologists by AfC pay band by NHS Trusts: Kent, Surrey and Sussex ............................................................................... 69

Table 12 Number of clinical psychologists by AfC pay band by NHS Trusts: Health Education North East .......................................................................... 71 Table 13: Number of clinical psychologists by AfC pay band by NHS Trusts: North West ..................................................................................................... 72

Table 14 Number of clinical psychologists by AfC pay band by NHS Trusts: North West London ........................................................................................ 74 Table 15 Number of clinical psychologists by AfC pay band by NHS Trusts: South London................................................................................................. 76



Table 16 Number of clinical psychologists by AfC pay band by NHS Trusts: North, Central and East London ..................................................................... 77 Table 17 Number of clinical psychologists by AfC pay band by NHS Trusts: South West .................................................................................................... 79 Table 18 number of clinical psychologists by AfC pay band by NHS Trusts: Thames Valley ............................................................................................... 80 Table 19 Number of clinical psychologists by AfC pay band by NHS Trusts: Wessex .......................................................................................................... 82

Table 20 Number of clinical psychologists by AfC pay band by NHS Trusts: West Midlands ............................................................................................... 83 Table 21 Number of clinical psychologists by AfC pay band by NHS Trusts: Yorkshire and Humber ................................................................................... 85 Table 22 Applied Psychology Workforce in Scotland: March 2015 ................ 86

Table 23 Age profile of Psychology Staff employed in NHS Scotland as at 31st March 2015 .................................................................................................... 86

Table 24 Male Clinical Psychologists employed in NHS Scotland as at 31/03/3015 ..................................................................................................... 87 Table 25 Female Clinical Psychologists employed in NHS Scotland as at 31/03/2015 ..................................................................................................... 88 Table 26 Ethnicity of staff employed in psychology services in NHS Scotland March 2015 .................................................................................................... 88 Table 27 Ethnicity of staff employed in psychology services in NHS Scotland: March 2015 .................................................................................................... 88 Table 28 Staff employed in Psychology Services in NHS Scotland with declared disability .......................................................................................... 89

Table 29 Staff employed in Psychology Services by Region and Health Board NHS Scotland March 2015 ............................................................................ 90

Table 30 Vacancies and posts under advertisement at 31/03/2015 ............... 92

Table 31 Pay band of staff employed in Psychology Services in NHS Scotland March 2015 .................................................................................................... 93 Table 32 Clinical psychology staff employed in NHS Scotland Psychology Services as at 31/03 2015 by area of work and target age of patients seen. . 93 Table 33 w.t.e Clinical Psychologists employed in NHS Scotland by area of work and year ................................................................................................ 94 Table 34 Staff employed in Psychology Services in NHS Scotland by type of contract .......................................................................................................... 95

Table 35 Headcount in training in Applied Psychology in NHS Scotland as at 30th June 2015. ............................................................................................. 95

Table 36 Low Attrition Rate of Doctorate in Clinical Psychology Trainees. .... 96 Table 37 Number of clinical psychologists in various age bands by Health Board: Wales ............................................................................................... 100

Table 38 Number of psychologists by gender: Health Boards in Wales ....... 100 Table 39 Ethnic breakdown of clinical psychologists: NHS Wales ............... 101 Table 40 Number of clinical psychologists in Wales by Health Board and by AfC Pay Band .............................................................................................. 103

Table 41 Number and w.t.e. of clinical psychologists in various age bands: Northern Ireland ........................................................................................... 105 Table 42 Number of clinical psychologists by gender: Northern Ireland (DHSSPS data) ............................................................................................ 107



Table 43 Number and whole time equivalent of clinical psychologists in Northern Ireland (DHSSPS data) ................................................................. 107 Table 44 Number of clinical psychologists by AfC pay band: Northern Ireland ..................................................................................................................... 108 Table 45 Headcount and Pay Band of Clinical Psychologists in Northern Ireland: DCP data ........................................................................................ 108 Table 46 Planned age of retirement ............................................................. 114 Table 47 Gender of survey respondents ...................................................... 116

Table 48 Ethnicity of survey respondents .................................................... 117 Table 49 Ethnicity of survey respondents .................................................... 118 Table 50 Percentage and number of clinical psychologists with main and subsidiary employers ................................................................................... 119 Table 51 Pay band now compared to 2 years ago ....................................... 121

Table 52 Mean hours of work with main and subsidiary employers ............. 125 Table 53 Estimated number and percentage of UK HCPC registered clinical psychologists working in various specialties ................................................ 127

Table 54 Number of clinical psychologists working with addictive difficulties: sessions per week ....................................................................................... 131 Table 55 Total sessions per week for clinical psychologists working with addictive difficulties ...................................................................................... 132

Table 56 Number of UK clinical psychologists working in adult IAPT services ..................................................................................................................... 134

Table 57 No. of clinical psychology sessions per week in adult IAPT .......... 134 Table 58Number of UK clinical psychologists working in adult mental health ..................................................................................................................... 137

Table 59 Clinical psychology sessions per week in adult mental health ...... 137 Table 60 No. of clinical psychologists working in child and family services . 139

Table 61 No. of clinical psychology sessions/week in child and family services ..................................................................................................................... 139

Table 62 No. of clinical psychologists working in clinical health services ..... 141 Table 63 No. of UK clinical psychologists working in clinical health services ..................................................................................................................... 142 Table 64 No of UK clinical psychologists working in commissioning ............ 143

Table 65 No. of sessions/week of UK clinical psychologists working in commissioning ............................................................................................. 144 Table 66 No. of clinical psychologists working sessions in consultancy ...... 145

Table 67 Total no. of sessions/week of clinical psychologists working in consultancy .................................................................................................. 146

Table 68 No. of UK clinical psychologists working in eating disorders ......... 147 Table 69 No. of sessions/week of UK clinical psychologists working in eating disorders ...................................................................................................... 147

Table 70 No. of clinical psychologists working in forensic services.............. 150 Table 71 No. of sessions/week of clinical psychology in forensic services .. 150 Table 72 No. of clinical psychologists working in HIV/sexual health ............ 152 Table 73 No of clinical psychology sessions/week in HIV/sexual health services ........................................................................................................ 153 Table 74 No. of UK clinical psychologists working in learning disability services ........................................................................................................ 155 Table 75 No. of UK clinical psychology sessions working in learning disability services ........................................................................................................ 156



Table 76 No. of UK clinical psychologists working in management ............. 157

Table 77 No. of clinical psychology sessions in management ..................... 158 Table 78 No. of UK clinical psychologists working in neuropsychology ...... 160

Table 79 No. of sessions/week in neuropsychology .................................... 160 Table 80 No. of UK clinical psychologists working in older adult services ... 162 Table 81 No of UK clinical psychology sessions/week in older adult services ..................................................................................................................... 163 Table 82 No. of UK clinical psychologists working in paediatric services ..... 165

Table 83 No. of UK clinical psychologist sessions/week in paediatric services ..................................................................................................................... 166 Table 84 No. of clinical psychologists working in perinatal services ............ 168 Table 85 No. of UK clinical psychology sessions in perinatal services ........ 169 Table 86 No. of clinical psychologists working in primary care services ...... 171

Table 87 No. of UK clinical psychology sessions/week in primary care services ........................................................................................................ 172

Table 88 No. of clinical psychologists working in teaching/training others ... 175

Table 89 No. of UK clinical psychology sessions/week in teaching/training others ........................................................................................................... 175 Table 90 No. of UK clinical psychologists working in teaching/training clinical psychologists ............................................................................................... 178

Table 91 No. of UK clinical psychology sessions/week in teaching/training psychologists ............................................................................................... 178

Table 92 No. of clinical psychologists working in university/higher education ..................................................................................................................... 181 Table 93 No. of UK clinical psychology sessions/week in university/higher education ..................................................................................................... 182 Table 94 No. of UK clinical psychologists working in "other activities" ......... 184

Table 95 No of UK clinical psychology sessions in "other work" .................. 185

Table 96 No. of clinical psychologists’ members of BPS and DCP (online survey) ......................................................................................................... 187 Table 97 Clinical Psychologists' current analysis of service needs and gaps ..................................................................................................................... 195 Table 98 UK Training places for Clinical Psychology per head of population ..................................................................................................................... 209 Table 99 HSCIC Reasons for Leaving and Staff Movements ...................... 210 Table 100 Assumptions of DCP Workforce Model (demonstration data) ..... 211

Table 101 Baseline estimates of clinical psychology workforce demand (demonstration data only) ............................................................................ 212

Table 102 Planned percentage changes in workforce by specialties (demonstration data only) ............................................................................ 212 Table 103 Demonstration output: Supply and Demand & Training Surplus/Deficit .............................................................................................. 213



1 EXECUTIVE SUMMARY

1.1 Aims of the Project

The Division of Clinical Psychology (DCP) of the British Psychological Society (BPS) commissioned an important UK-wide Clinical Psychology Workforce Project with two main aims:

1) To gain a more accurate profile of the number and whole time equivalent (w.t.e.) profile of clinical psychologists in the UK, including gaps and inequities in service provision. For instance:

Clinical psychology workforce by demography (age, gender, ethnicity), pay band, type of contract/hours or work, employer type, geographic location)

Clinical psychology specialisms (also by demography, pay band, type of contract/hours or work, employer type, geographic location

Linking the above profiles to other indexes of need (e.g. index of multiple deprivation; population of area, NICE guidance etc)

2) To identify and promote the important roles and increasing demand for clinical psychology skills in the delivery of health and care in both the public and private sector, linked to national policies and increased public demand for high quality psychological services

1.2 Key findings

The key findings of this project are outlined in data sources referenced in Sections 5; 6; 7; 8; and 9.

1.2.1 Demography

Around 80% of clinical psychologists are female (see 5.1) and this has implications for part-time working related to child-care and other caring responsibilities. There will be a need to ensure that training places match the requirements for part-time working and locum cover during periods of parental leave (see 10.8).

The modal age group for UK clinical psychologists is ages 35-39 and the mean age is c. 42 years overall (see 5.1; 6.1; 7.1; 8.1;).

A significant number of UK clinical psychologists intend to retire at age 55 (linked to mental health officer status) or at age 60 and this has implications for future service demands (see 10.1.1).

There are an increasing number of clinical psychologists in practice from black and minority ethnic groups (see 6.3; 7.3; 8.3) but this percentage still falls short of BME representation in the general population of the UK.



1.2.2 Geographic distribution: equity of provision

There are significantly fewer clinical psychologists per 100,000 head of population in Northern Ireland and Wales (see 5.3).

There are considerable inaccuracies in the central statistical information collected on numbers of qualified clinical psychologists with misattribution of other non-clinical psychology staff allocated to clinical psychology grades. This has resulted in an overall 10-15% over-estimate of the clinical psychology workforce (see 6.5.1; 9.2). This introduces a significant error factor in relation to current and future supply and demand modelling for clinical psychology.

There is also considerable variation in numbers and gradings of psychologists between various Regions and NHS Trusts within Regions (see 6.4; 6.5; 6.6; 7.5; 8.4; 9.2.1).

1.2.3 Impact of austerity

There is evidence that a number of clinical psychology senior posts have been down banded over the last 5 years; related to the climate of austerity in NHS and other public services and the requirement to meet cost-saving targets. This has been associated with loss and diffusion of leadership in some services (see 10.30.3).

1.2.4 Areas and sectors of work

Clinical psychologists work in a wide variety of specialties and areas of work (see 7.8; 9.2.2; 10.9). Around 80% of UK clinical psychologists work in the following specialisms (in descending order) – see 7.8; 9.2.2; 10.9)

Adult Mental Health

Child and Family

Learning Disabilities

Clinical Health Psychology

Neuropsychology

Older Adults

Forensic

Paediatric psychology

Management

Teaching and training others

The majority of UK clinical psychologists work in secondary and tertiary care services with only around 13% in primary care and 10% in higher education (see 10.9.1)



Developing areas of practice include services for older adults, sexually transmitted disease, addictions, long term physical health conditions, autism and Asperger’s Syndrome and brain injuries services.

Although the vast majority of UK clinical psychologists work in NHS services, there is an increasing trend for clinical psychologists to have some employment (or self-employment) outside their main NHS employment (see 10.4). Around 15% of clinical psychologists undertake additional employment of this type and this may represent a growing trend as people seek to diversify their prospects for income and career progression.

Most clinical psychologists (80%) have permanent employment contracts with the NHS but there has been some increase in fixed and short term employment contracts and locum work (see 7.9; 9.2.3; 10.7)

However, there are generally very high levels of retention of clinical psychology staff within NHS services (see 7.119.2; 12.3) and very low attrition from clinical psychology training courses.

This survey likely under-represents those psychologists engaged in independent practice as it is difficult to collect information about the range of organisations (often small or individual practices) involved in delivering care to this sector.

1.2.5 Professional membership

Around two thirds of online survey respondents were full members or in-training members of the DCP (see 10.29) However, 13.5% were not members of the DCP and 20% were not members of the BPS. A number of respondents reported that as they had to register with HCPC they did not see added value in becoming members of the BPS. This indicates that they did not recognise HCPC prime function as a regulatory body rather than a professional body supporting the development of psychology. 1.2.6 Key themes, concerns and service gaps

A narrative analysis of survey responses (n=1126) regarding clinical psychologists issues and perceived service gaps (see 10.30) revealed the following key concerns:

Lack of career progression

1. Preceptorships not used 2. Bands 7/8a career grade now, limited senior roles to apply to 3. Clinical psychologists moving areas, working part time, moving specialty

to progress 4. Not supported with Continuing Professional Development to progress



“More for less” demanded

5. Down-banding of posts 6. Same pay, expected to do more 7. Newly qualified staff doing more in role than in past 8. Non-clinical psychologists doing parts of clinical psychologist role for less

money

Need for broader working

9. Need to broaden role from just therapy e.g. consultancy, teaching, research

10. Not enough time to use other skills e.g. research, service development 11. Split in responses as some do not want to broaden their role out of tier 4

therapy 12. Need individuals to show more leadership

“Too much pressure”

13. Reduced funding, fewer clinical psychologists but waiting lists going up 14. Limiting targets reducing flexibility/creativity 15. High risk and complexity of case work

Non-NHS work in other public sector/independent and third sectors

16. Creative work possible, can be more rewarding 17. Feeling forced out of NHS due to lack of career progression, the pressure

etc. 18. Need more support for non-NHS clinical psychologists from DCP/BPS 19. Trainees should be trained for working in non-NHS sectors too 20. Other organisations filling gaps in NHS services

Leadership needed

21. DCP needs to be stronger, advocate more and challenge more 22. Clinical psychologists need more training in leadership 23. Clinical psychologists need to undertake more management roles 24. Leadership roles key for clinical psychologists in services as managers

and Board members 25. Want clarity on “what DCP is for” and why psychologists should join 26. Want DCP to be like Royal College of Psychiatrists

Career structure issues

27. Loss of Assistant Psychologist role 28. Loss of senior posts limiting supervision 29. Progression from undergraduate to consultant clinical psychologist

unclear in NHS 30. Guidelines needed for what each grade of psychologist does/key

competences 31. Neuropsychology training issues- access limited for many practising

Physical health development



32. Potential for increasing clinical psychologist roles in health services 33. Preventative and wellbeing promotion work

Resilience issues

34. Burn out, stress and demoralised by work pressures and bullying/blame culture

35. Clinical Psychologists well placed to lead to supporting others to be resilient

36. Need protected time for reflection and resilience building

Uncertainty about future

37. Ongoing threats of service reviews and down banding 38. More temporary or fixed term contracts 39. Future of profession in NHS unclear

1.2.7 Areas of development

Areas of service development and expansion include:

General/physical health

Older adult/dementia services

Psychosis/inpatient services

Personality disorder

Private/independent practice

Work for third sector/local authority/social care

Child/CAMHS services

Autism/Asperger’s Syndrome

Neuropsychology/brain injury services

Forensic services

Occupational health

Training others/supervision

Complex case formulation

Management and leadership of services

Role in accreditation/regulatory bodies

Commissioning and service development



1.3 Recommendations

The following recommendations arise from this project and need to be prioritised for further discussion and development:

1.3.1.1 Robust needs analysis

1. A systematic analysis of need for current and future clinical psychology services linked to national policies, best practice guidance (e.g. NIHCE guidance) and research evidence needs to be undertaken.

2. Evidence-based norms for high quality, effective clinical psychology services need to be developed and disseminated to service commissioners and providers and existing BPS guidance should be updated.

1.3.1.2 Developing a robust workforce plan and model for clinical psychology

1. There is an urgent need to develop more robust supply and demand modelling for clinical psychology on a National basis.

2. Workforce development for clinical psychology should be underpinned by national policy implementation requirements and thorough analyses of needs, linked to sociodemographic indicators and the views of actual and potential service users and carers.

3. The workforce plans should include realistic assumptions about workload and specification of outcome measures.

4. The workforce plan should address career progression pathways and key competences for each level of work

1.3.1.3 Addressing equity of provision

1. Geographic and socio-demographic inequities in provision of clinical psychology services should be identified and addressed by those lead psychologists and those responsible for commissioning services to ensure fair and equitable access to services.

2. Retirement profiles and increased part-time working trends should be identified and addressed to ensure current and future continuity and stability of services

1.3.1.4 Expanding areas of need and demand

1. Clinical psychology workforce plans need to include the increasing requirements from non-mental health NHS services (e.g. physical health1, child health) for clinical psychologists' expertise .

2. An increased role in primary prevention of psychological distress and more engagement in early intervention/primary care services are under-developed areas for clinical psychology.



1.3.1.5 Scoping needs of non-NHS public and independent sector

1. The needs of non-NHS employers including other public sector, private, independent and voluntary sector organisations need to be identified and to inform future training commission provision

1.3.1.6 Improving accuracy of data

1. Workforce planning for clinical psychology needs to be predicated on accurate baseline data. Inaccuracies and coding anomalies need to be addressed at national and local level and any misrepresentations in supply and demand modelling need to be rectified.

1.3.1.7 Engaging psychology leads in workforce planning

1. Clinical psychology leads should be involved in workforce planning and check the accuracy of their local workforce information

2. Ensure that leadership and consultant clinical psychology posts are maintained at a sufficient level to maintain and promote service 18. Clinical psychology service leads should be fully involved in shaping current and future workforce plans for clinical psychology with senior managers, directors of their organisations and commissioners of service.

1.3.1.8 Leadership

1. Improve the quality and development and to manage clinical risk through expert supervision and guidance in psychological practice both within and outside the profession.

2. Development opportunities for extended clinical and leadership roles (including management and commissioning of services) should be identified and supported in accordance with recommendations of the Rose Review2.

3. Psychology leads should contribute to leadership and development in provider, commissioning and accrediting or training bodies.

4. Strengthen local, Regional and National alliances to support clinical psychology service development. The BPS/DCP can play a pivotal role in promoting this professional structure and links to other key stakeholders, including service users and carers.

1.3.1.9 Impact of austerity

1. A more thorough analysis of the impact of down banding and loss of posts in service areas is needed, with a requirement to address areas where this has clearly resulted in decreased quality and access to psychological intervention. The impact on clinical psychology staff morale and effectiveness should also be assessed and addressed.

2. Evidence for the cost-effectiveness of psychologically informed systems of care and interventions should be developed and disseminated to provider—managers and commissioners of service.



1.3.1.10 Wider roles for clinical psychologists in systems and development of evidence-based practice and quality of healthcare

1. The wider contribution of clinical psychologists in consultancy, service development and management, research, development of outcome and clinical standards measures needs to be acknowledged and developed in health and care systems.

2. Supervision, reflective practice, and teaching/ higher education are key areas to maintain quality and effectiveness of psychological service provision.

3. The depth and breadth of clinical psychology training uniquely equips clinical psychologists to undertake a broad role in health and care design, development and delivery; including development of the evidence base for interventions and outcome measures. This includes the development of innovative, integrated services to improve health and wellbeing and prevention of distress.

4. Providers and commissioners should identify clinical risks associated with of poor quality of care and clinical outcomes if therapies and psychological interventions are misapplied and clinical psychologists can play a lead role in the governance, quality assurance and accreditation of such interventions.

1.3.1.11 Training and supply of clinical psychologists

1. .A raft of national government policies highlight the contribution of psychological science in their development and implementation requirements, pointing to an increased demand for clinical psychology skills and expertise (see Section 3).

2. No further cuts to clinical psychology training should be envisaged until the policy implementation requirements for clinical psychologists have been fully scoped and analysed, as converging evidence would suggest the need for an increase rather than decrease in such posts is indicated. Psychology leads in a number of specialties report difficulties in filling some psychology vacancies, indicating a buoyant demand for clinical psychologists.

3. 17. The British Psychological Society should collate and provide increased evidence of the cost-effectiveness of their service delivery for the health and care economy

1.3.1.12 Resilience and capacity building.

Strategies for improving the resilience and wellbeing of the clinical psychology workforce need to be developed, including access to appropriate supervision, continuing professional development and personal support . This will help to address issues of burnout and low morale and improve the quality of service for service users and carers.



1.3.1.13 New models of applied psychology in health and care?

1. Development of new models of service delivery for clinical psychology should be evaluated including the potential for broader applied psychology services incorporating clinical, counselling, forensic, health and occupational psychologists offering flexible, tailored services to a variety of provider and commissioning organisations

2 INTRODUCTION AND OVERVIEW

The Division of Clinical Psychology (DCP) of the British Psychological Society (BPS) commissioned an important UK-wide Clinical Psychology Workforce Project with two main aims:

1) To gain a more accurate profile of the number and whole time equivalent (w.t.e.) profile of clinical psychologists in the UK, including gaps and inequities in service provision. For instance:

Clinical psychology workforce by demography (age, gender, ethnicity), pay band, type of contract/hours or work, employer type, geographic location)

Clinical psychology specialisms (also by demography, pay band, type of contract/hours or work, employer type, geographic location

Linking the above profiles to other indexes of need (e.g. index of multiple deprivation; population of area, NICE guidance etc)

2) To identify and promote the important roles and increasing demand for clinical psychology skills in the delivery of health and care in both the public and private sector, linked to national policies and increased public demand for high quality psychological services

However, there are increasing pressures in some Regions including cuts to clinical psychology training places and loss and down banding of clinical psychology posts A review of the clinical psychology workforce in West Midlands undertaken by Woodcote Consulting has been influential in stemming further cuts to training in this Region but there is no room for complacency.

Major current healthcare national strategies such as Five Year Forward View3 and best practice guidance, highlight the need for Clinical Psychology involvement in the development and delivery of services; including the involvement of Clinical Psychologists in the development of policy and standards for services. The future clinical psychology workforce needed over the next 5-10 years must be fully identified.

A clear scoping of the range of current and future NHS and non-NHS employer organisation needs for Clinical Psychology is required. This needs to be linked with projected future demand for training commissions for clinical psychology.

We also need to identify the non-clinical work of psychologists (e.g. organisational/transformational consultancy, optimising care pathways,



projects/service evaluations, development of outcome and clinical standards measures, service management, commissioning/needs analysis, supervision and training of others etc). Also, extended clinical roles for psychology (e.g. Approved Clinician training).

United Kingdom DCP Branch Chairs and local psychology service leads were prompted to engage with this project which has national support and can influence the shape of the future clinical psychology workforce.

Psychology leads in each Region helped to coordinate this work and to verify the accuracy of census information. Some recommendations for improving data quality and accuracy for forecasting current and future needs are an integral part of this work.

In some areas, clinical psychology services are surviving and thriving. It is important to understand the key success factors associated with maintaining and improving professional profile and resilience in times of austerity. There are clearly some great disparities between localities in terms of the numbers and seniority/leadership of posts. Some psychologists have formed successful alliances with Service Provider Board members and Commissioning Directors to highlight current and future needs. It is important to disseminate this learning to current and emerging leaders of the profession. A structured interview process and collation of any relevant background material will assist the development of best practice guidelines in this area.

3 POLICY AND PRACTICE CONTEXT

It is important to situate any review of clinical psychology workforce planning in the context of key national strategies and policy implementation related to the delivery of health and care and the promotion of well-being. A current and expanding need and role for clinical psychology expertise in implementation of major national healthcare policies is evident, although not always fully acknowledged by commissioners and providers of services.

3.1 Epidemiology

A recent WHO report4concludes that globally, more than 25% of all years lived with disability and over 10% of the total burden of disease is attributable to mental, neurological and substance misuse disorders. Left unaddressed, lost economic output due to these disorders will increase significantly from the already enormous levels. Feasible, affordable and cost-effective measures are available for preventing and treating these conditions. The European Union also acknowledges the need to improve the mental health of the population5 and implement an EU strategy to address this.

One in 4 people suffer from poor mental health and this has an enormous impact on personal, social and economic well-being. One in 10 children have clinically significant psychological problems and there is an increasing need for early intervention services to address these issues and prevent lifelong mental health disability.



Rising trends in male suicide and self-harm also attest to rising needs for services.

Demographic trends linked to an ageing population mean that there is an increasing demand for older adult services associated with dementia and the psychosocial sequelae of living with long term illness and disability.

3.2 Policy Context

There is a plethora of a health and care National and Local policies and good practice guidance relevant to current and future demand for clinical psychology services.

Some areas include:

National Reviews (e.g. Francis report)

Health Education England, Scotland, Wales and Northern Ireland guidance of workforce needs and training

British Psychological Society policy and practice guidance

Care Quality Commission (local and national service reviews)

Any Qualified Provider and the mixed economy of care delivery

NHS England, Scotland, Wales and Northern Ireland

Training and supervision of others and associated National Accreditation

Public Health

NICE guidelines (mental and physical health)

3.3 “No Health without Mental Health” Strategy

The Department of Health 2011 Mental Health Strategy for England "No Health without Mental Health" stated that mental health must have equal priority with physical health, that discrimination associated with mental health problems must end and that everyone who needs mental health care should get the right support, at the right time. Tackling premature mortality of people with mental health problems is a priority. More must be done to prevent mental ill health and promote mental wellbeing. The six priorities are:

More people will have good mental health

More people with mental problems will recover

More people with mental health problems will have good physical health

More people will have a positive experience of care and support

Fewer people will suffer avoidable harm

Fewer people will experience stigma and discrimination



Key commitments include:

to improve mental health services, providing cost-effective evidence-based treatments;

to ensure early and accurate identification of health needs6;

to tackle the underlying cause of mental ill health and to reduce social inequality;

to invest in prevention and recovery services across the lifespan (and across physical-mental health boundaries);

To improve patient experience, safeguard patient safety, measure outcomes, provide strong clinical leadership and clinical governance, whilst also providing value for money.

The Mental Health Strategy recognises that early interventions can help reduce the estimated £105 billion annual costs to the economy of mental ill health. Early interventions that lead to good outcomes will be required for successful delivery of the 2011 Mental Health Strategy. The Mental Health Strategy also prioritises psychosocial interventions and includes a commitment to further increase investment in evidence-based psychological therapies.



Figure 1 Mental Health Dashboard



3.4 Closing the Gap and Parity of Esteem

Parity of esteem7 is the principle by which mental health must be given equal priority to physical health and was enshrined in law by the Health and Social Care Act 2012 and to operationalise through the NHS Mandate8.

People with severe mental illness die on average 20 years younger than the general population.

The proportion of people between 16 and 64 meeting the criteria for one common mental disorder increased from 15.5 % in 1993 to 17.6 % in 2007. Only a minority of people with mental health problems in England, with the exception of those with psychosis, receive any intervention for their problem.

Overall, the evidence suggests that at least 30% of all people with a long-term condition also have a psychological problem. By interacting with and exacerbating physical illness, co-morbid mental health problems raise total healthcare costs by at least 45% for each person with a long-term condition and co-morbid mental health problem.

In "Closing the Gap: Priorities for essential change in mental health"9 the following priorities are outlined

Increasing access to mental health services

Integrating physical and mental health care

Starting early to promote mental wellbeing and prevent mental health problems

Improving the quality of life of people with mental health problems

3.5 Better Access

Better access to mental health services10 is a Department of Health priority and an additional £40 million funding boost for mental health services in 2014-15 is committed This comprises:

an investment of £7 million to end the practice of young people being admitted to mental health beds far away from where they live, or from being inappropriately admitted to adult wards; and

An investment of £33 million to support people in mental health crisis, and to boost early intervention services, that helps some of the most vulnerable young people in the country to get well and stay well.

An £80 million investment will deliver:

Treatment within 6 weeks for 75% of people referred to the Improving Access to Psychological Therapies programme, with 95% of people being treated within 18 weeks.



Treatment within 2 weeks for more than 50% of people experiencing a first episode of psychosis.

A £30 million targeted investment will help people in crisis to access effective support in more acute hospitals.

3.6 Annual Report of the Chief Medical Officer 2013 Public Mental Health Priorities: Investing in the Evidence

This wide-ranging report of Dame Sally Davies, Chief Medical Officer, covers a number of areas of key priority for mental health service development. The report raises concerns about 70 million working days lost to mental illness and £70-£100 billion cost to the economy; calls for cost-benefit analysis to investigate possible fast-track mental health care for working people at risk of falling out of work; makes a case for investment in children and young people’s mental health to prevent later life mental illness, unemployment and criminal behaviour; and calls for piloting services integrated into primary care.

The report finds that: 75 per cent of people with diagnosable mental illness receive no treatment at all; there is a need for greater focus on mental health care for children and young people; and there should also be a greater focus on the link between long-term physical conditions and mental illness.

3.7 The Francis Report

The Francis Inquiry report was published one year ago on 6 February 2013 and examined the causes of the failings in care at Mid Staffordshire NHS Foundation Trust between 2005-2009. The report makes 290 recommendations, including: openness, transparency and candour throughout the healthcare system (including a statutory duty of candour), fundamental standards for healthcare providers, improved support for compassionate caring and committed care and stronger healthcare leadership.

3.8 NHS England 5 Year Forward View

The NHS 5 Year Forward View11 emphasises prevention of ill health related to obesity, smoking and alcohol misuse and recommends setting up workplace incentives to promote employee health, backed by stronger public-health related powers for local government. Supporting people to get and stay in employment is a key goal with a focus on mental health and disability. Incentivising and supporting healthier behaviour will be key to success.

Patients will gain greater control over their own care with the option of shared health and social care budgets and more support for unpaid carers. Greater use of technology in the diagnosis and management of health conditions will be increasingly important and to help people manage their own health.

Breaking down the organisation barriers between community and hospital care and between mental and physical health is emphasised, recognising that many people have complex, longer term multiple health conditions not just single disease. People with mental health problems die on average 15-20 years



younger than those who do not have these problems. Innovative and locally flexibly care delivery will be promoted. More support for people with dementia to remain healthy and active in the community is highlighted. Further development of liaison psychiatry and mental health support to hospitals and improvement in crisis care, including links with the criminal justice system will ensure improved access to care.

There is a commitment to achieve parity of esteem12 between physical and mental health and to reduce the waiting time for psychological and treatment for a first episode of psychosis, including more inpatient facilities and comprehensive mental health services for young people.

NHS Policy as outlined in 5 Year's Forward lays out a vision for very substantial redesign of models of care to enable the UK health and care system to deal with the challenges it faces.

The details of the redesign required have not been mandated, with policy allowing local variation and experimentation to meet local needs. There are a number of pilot projects (probably around 70 in various programmes) with varying scope and scale, but all represent steps towards creating Accountable Care Organisations (ACOs) – Organisations with a single budget to deliver all care to a defined population

All of these pilots have some common themes:

Integration across health and care and into wider public services (particularly criminal justice and education).

Greater engagement of patients, service users and family/informal carers.

The use of digital technologies to enable self-service, digital delivery and Big Data analytics.

There is also a significant secondary “Wealth” agenda in many of the pilots to create economic opportunity for the national and local economies.

ACOs will take a more holistic view of the cost of individual citizens to the systems and in particular focus on those individuals and groups with long-term conditions and/or complex needs who consume a disproportionate proportion of resources.

NHS Policy as outlined in 5 Year Forward View lays out a vision for very substantial redesign of models of care to enable the UK health and care system to deal with the challenges it faces.

Three areas of opportunity open here for clinical psychology:

More effective formulation with people presenting with mental health problems to ensure people are directed to appropriate services and that those with severe and enduring problems (including personality disorder) who consume disproportionate resources across mental and physical health services, social care and criminal justice.



More active engagement in physical health (as there is clear evidence for the impact of psychological factors in long-term conditions, with these typicality be the most significant determinant of outcome and quality of life).

The application of the analytical and research skills of clinical pathologist in the use of Big Data and service redesign – The training and academic calibre of the profession makes them significantly more able in this area that most other sections of the workforce.

The challenge for the profession falls in to three areas:

The identification and/or creation of new systems of care in mental and physical health that make the best use of clinical psychology expertise.

Gathering the data to demonstrator the cost and quality benefits that flow from the application of these models to commissioners.

The active engagement of practitioners in developing, promoting and engaging in these new systems of care.

3.9 Outcomes framework

Key policy outcomes are outlined in this Section in relation to NHS, Public Health and Social Care policies. Commissioners have increasing amounts of guidance and tools to assist them in achieving health outcomes from their investment13

3.9.1 NHS outcomes framework

The NHS has adopted an outcomes framework as part of “The Mandate14” from the Department of Health for local healthcare commissioners and providers. The outcomes framework also includes improving outcomes from psychological therapies and a "mental health dashboard" of performance indicators and measures to underpin this15.



Figure 2 NHS Outcomes Framework

Key drivers Relevant policy

1.Cross-Government outcome strategy

Public Health England is charged with raising mental health as a

key workforce priority. The benefits of early intervention are

acknowledged and this strategy aims to further promote mental

health.

No health without mental

health: a cross-Government

mental health outcomes

strategy for people of all ages

- a call to action (DH, 2011a)

2.Improving Access to Psychological Therapies

As part of the outcome strategy outlined above, investment is

pledged for the Improving Access to Psychological Therapies (IAPT)

programme to increase the workforce to approximately 6000

cognitive behaviour therapy staff and expand access to children

and young people, older people, carers, those with long-term physical conditions and severe mental health needs. This is the

second stage in this national programme that originally focused on

adults of working age. It continues to affect the type of staff typically

involved in delivering cognitive behaviour therapies in the NHS.

Applied psychologists continue to be involved in both designing and delivering the IAPT programme.

Talking therapies: A four-year

plan of action - A supporting

document to No health

without mental health: A

cross- government mental health outcomes strategy for

people of all ages (DH,

2011b)



3.9.2 Public health outcomes

Table 1 Public Health Outcomes

3.9.3 Social care outcomes

The social care outcomes framework is summarised below and further referenced16

Table 2 Social Care Outcomes Framework



3.10 Evidence-based best practice

There is a raft of NICE best practice guidance for clinical health and care delivery (see http://www.nice.org.uk/guidance/lifestyle-and-wellbeing/mental-health-and-wellbeing ) which in many instances details specific roles for psychologists in service delivery of NICE compliant interventions and therapies.

3.11 Influencing behaviour through public policy

The Cabinet Office Mindspace Document17 acknowledges that "influencing behaviour is central to public policy challenges such as crime, obesity or environmental sustainability. Behavioural approaches offer a potentially powerful new set of tools. Applying these tools can lead to low cost, low pain ways of “nudging” citizens - or ourselves - into new ways of acting by going with the grain of how we think and act. This is an important idea at any time, but is especially relevant in a period of fiscal constraint".

A recent independent evidence-based Commission18, chaired by Liberal Democrat MP Paul Burstow goes further stating:

"We must prioritise the promotion and protection of the wellbeing and mental and social capital of the nation. The pursuit of happiness should be a goal of government.

The promotion of wellbeing requires a co-ordinated approach with both universal services and targeted interventions. A well-designed and delivered wellbeing programme can over time reduce the burden of mental health problems.

Primary care organisations must be equipped to recognise and meet the mental health needs of their patients.

Investment in the wellbeing and mental health of our children and young people should be a priority and would reduce the lifetime cost of mental health problems.

Timely identification and access to the right treatment requires effective collaboration between schools and child and adolescent mental health services"

3.12 Mental Capital and Wellbeing

The Government Department for Innovation, Universities and Skills commissioned a report entitled "Mental Capital and Wellbeing: Making the most of ourselves in the 21st Century19 which focuses on a broad canvas of mental health related issues and interventions of social relevance detailed in the Figure below. Again, applied psychologists have much to contribute in this area.

http://www.nice.org.uk/guidance/lifestyle-and-wellbeing/mental-health-and-wellbeing

http://www.nice.org.uk/guidance/lifestyle-and-wellbeing/mental-health-and-wellbeing



Figure 3 Mental Capital and Well-being



There is recognition at the highest government level (https://www.gov.uk/government/organisations/behavioural-insights-team/about). The Behavioural Insights Team, often called the ‘Nudge Unit’, applies insights from academic research in behavioural economics and psychology to public policy and services and considers the application of behavioural science to policy design and delivery, advancing behavioural science in public policy and championing scientific methodology to bring greater rigour to policy evaluation20. Clearly, the wider implications of the application of psychological science to the delivery of health and care services should be cascaded down to improve systems of care.

Within NHS Scotland21, recent years has seen an unparalleled demand for increased access to Applied Psychologists and Psychological Therapies. A demand from both patients and professionals has arisen due to the ever increasing evidence base for psychological interventions.

The second round of the National Audit of Psychotherapies22 found that whilst there have been some improvements since the baseline, including reduced waiting times and better recording of ethnicity and diagnostic data, there are a number of ongoing areas of concern. There is still marked variation in performance between services, some therapies are still being provided by therapists who do not have specific training to do so and older adults with anxiety and depression are not getting the help they need.

3.13 Roles of Clinical Psychologists

Practitioner psychologists have much to contribute to the achievement of the policy implementation outcomes associated with various current health and care strategies.

The British Psychological Society has recently published a paper: "National Mental Health, Well-being and Psychological Therapies - the role of Clinical Psychology - A briefing paper for NHS Commissioners23.

3.13.1 Evidence-based practice

Clinical Psychologists apply the science of Psychology to a range of clinical health care services and settings. Clinical Psychologists use this knowledge to design, implement and evaluate health care services that enhance well-being and minimises ill health and impairment. They are trained to apply their knowledge in systematic methods and practice which are scientifically evaluated and to test clinical practice for its effectiveness

A framework for Clinical Psychology in a mental health context is based around five strategic purposes:

to prevent mental and physical ill health from occurring in the first place;

to prevent anyone with mental ill health from deteriorating;

to restore anyone with mental ill health back to their normal level of independent life and beyond;



to support and raise the standard of independent life amongst those with chronic mental ill health;

To facilitate a sustained approach to prevention.

3.13.2 Range of interventions based on psychological theory and science

Psychologists have a key role in implementation of the Department of Health "Talking Therapies: a four year plan of action"24

Formulation is a core skill for all Clinical Psychologists25. It can be described as a summary of an individual’s difficulties, grounded in psychological theory, and indicating the most appropriate intervention. The Core Purpose and Philosophy of the Profession (DCP, 2010, pp.5-6) states:

Psychological formulation is the summation and integration of the knowledge that is acquired by this assessment process that may involve psychological, biological and systemic factors and procedures. The formulation will draw on psychological theory and research to provide a framework for describing a client’s problem or needs, how it developed and is being maintained. Because of their particular training in the relationship of theory to practice, clinical psychologists will be able to draw on a number of models (bio-psycho-social) to meet needs or support decision making and so a formulation may comprise a number of provisional hypotheses. This provides the foundation from which actions may derive. Psychological intervention, if considered appropriate, is based upon the formulation.

Research has shown that formulation can serve a range of purposes for teams, including generating new ways of thinking, achieving a consistent approach to intervention, helping to manage risk, and raising staff morale.

Clinical psychologists offer a range of expertise in relation to healthcare delivery:

Individual, family and group assessment and therapies

Supervision and teaching other professions to provide psychological treatments to ensure best practice and minimise risk.

Expertise and leadership26 in organisational development, audit, service redesign, and policy development.

Innovative service development and re-design in health and care services.

Leadership and support to teams of clinical workers in providing psychologically informed assessment and treatment.

The combination of indirect application skills (e.g. expert supervision, consultancy and problem solving skills, teaching and training, service development can help provider and commissioning organisations ensure that clinical governance standards are maintained.



Band 7 clinical psychologists are multimodal therapists and are able to work with all levels of complexity of psychological needs.

3.13.3 Competence frameworks for the delivery and supervision of Psychological Therapies

The second round of the National Audit of Psychological Therapies27 found that whilst there have been some improvements since the baseline, including reduced waiting times and better recording of ethnicity and diagnostic data, there are a number of ongoing areas of concern. There is still marked variation in performance between services, some therapies are still being provided by therapists who do not have specific training to do so and older adults with anxiety and depression are not getting the help they need most.

3.13.3.1 UCL Competence frameworks

There are currently nine competence frameworks available to download (www.ucl.ac.uk/CORE/). Four of these focus on the main therapeutic approaches utilised by psychological therapists:

CBT

Humanistic

Psychoanalytic/Psychodynamic

Systemic

These map on five domain competencies including generic therapeutic competencies and four therapy specific competencies; basic; specific; problem specific; metacompetences.

The fifth competency framework available is Supervision.

The supervision map locates only four domains; generic supervision; specific supervision; model specific supervision; metacompetences supervisors need to apply across all the other domains of the framework, these are usually examples of higher-order decision making.

3.13.3.2 National Occupational Standards/Skills for Health28

The national occupational standards concentrate on a further four frameworks:

CBT

Humanistic

Analytic/Dynamic

Systemic



These frameworks can be accessed from the National Occupational Standards/ Skills for Health Website (www.skillsforhealth.org.uk/about-us/competence%10national- occupational-standards).

3.13.3.3 IAPT Competence frameworks

Four further frameworks were commissioned as part of the expansion to the IAPT programme to develop greater choice for those clients with depression:

1. Brief dynamic interpersonal therapy for depression

2. Interpersonal psychotherapy for depression

3. Couple therapy for depression

4. Counselling for depression

These can also be accessed through the IAPT website (www.iapt.nhs.uk/workforce).

3.13.3.4 Relationship between the competence frameworks and National Occupational Standards

The competence frameworks and National Occupational Standards are constituent parts of a programme overseen by the Department of Health. This has the objective of specifying occupational standards for the practice and training of psychological therapists, initially in four modalities (CBT, psychoanalytic/psychodynamic, systemic and humanistic person- centred/experiential).

Visit www.bps.org.uk/dcp for a full account of the relationship between these two pieces of work- Digest of National Occupational Standards for Psychological Therapies (Fonagy et al., 2010).

The competences from UCL present knowledge and ability progressively from the generic to the problem specific, with an emphasis on knowing what and knowing how. The NOS, in contrast, addresses the steps that a client will be taken through in therapy (the process). It concentrates on the therapist’s interdependent actions, from determining the suitability of therapy for a client, developing the manner of the intervention, and deciding how the therapy may be ended. The emphasis in the NOS is on what you can expect to be doing, as a therapist, or, as a client, what you can expect to experience or receive.

This methodology implies that the application of the NOS centres on the client problems that were included in the research at UCL.

3.13.3.5 UCL competence frameworks, produced by Roth & Pilling and colleagues

UCL competences focus on what the therapist needs to know in order to deliver the intervention.



Construction of the competence frameworks includes:

Generic Therapeutic competences in psychological therapy

Basic competences (related to the type of therapy)

Specific competences (related to the type of therapy)

Problem-specific competences

Metacompetences

3.13.3.6 Modality specific competence frameworks:

Cognitive and Behavioural Therapies

Psychoanalytic/Psychodynamic Therapies

Systemic Therapies

Humanistic Therapies

Extended to frameworks for the expansion of IAPT:

Interpersonal Psychotherapy (IPT)

Dynamic Interpersonal Therapy (PIT)

Counselling for Depression

Couples Therapy for Depression

3.13.4 Governance, risk management and quality assurance

Clinical psychologists have much to offer in terms of clinical governance to promote safety and quality in care delivery

3.13.5 Training and Supervision

All psychological therapists require supervision and there are potential governance, safety and risk issues if clinical psychology posts are reduced. Clinical psychologists can promote psychological informed care systems, based on a scientific, evidence-based approach to service development along the lines recommended in the Berwick Report.29

3.13.6 Research and service development and innovation

Effective investment in the promotion of positive mental health and prevention and recovery services across the lifespan (and across physical-mental health boundaries) can promote cost-effective service delivery.

Clinical Psychologists can apply a range of evidence-based treatments. Research expertise delivered into services creates a unique science-based clinical profile, bringing clinical expertise in psychological approaches to health, well-being and performance, utilising both direct and indirect



applications. Clinical psychologists can support a continually developing evidence base so that current services can be improved and supporting timely and cost-effective application in a range of services across the lifespan. For instance, this includes:

problem solving approaches to address the psychosocial determinants of ill health;

innovative service development in acute services;

co-ordinated intervention for co-morbid physical and mental health problems;

assessment and formulation to address medically unexplained symptoms;

interventions that promote resilience and coping, enabling employment;

Comprehensive science-based assessment to identify effective strategies and minimise waste.

This can help to reduce waste of resources and thus promote cost-effective delivery of healthcare through expert, reliable and high quality assessment of need followed by psychological formulation grounded in psychological theory, science and best practice to guide the most appropriate individual or team interventions.

Clinical psychologists can promote psychologically informed health and care systems.

3.13.7 Leadership Skills of Clinical Psychologists

Clinical psychologists are well-placed through their undergraduate and postgraduate professional training to offer clinical leadership in a variety of services30 and often become involved in management and service improvement work. This is consistent with the recommendations of the "New ways of Working for Applied Psychologists in Health and Social Care"31



Figure 4 Leadership skills of Clinical Psychologists

2. What combination of skills do I as a clinical psychologist bring to leadership?

Post-Grad Doctoral Trainee Clinical Psychologist

Practising Clinical Psychologist

Consultant Clinical Psychologist

Clinical Director

Clinical ■ Formulation skills from more than one

psychological model to inform

interventions.

■ Awareness/building/

maintenance of interpersonal

relationships.

■ An understanding of the emotional

impact of change (including resistance).

■ Self-reflection/helping others self-

reflect.

■ Emotional I n t e l l i ge n ce /resilience.

■ Able to lead on complex psychometric

testing.

■ Comprehensive

psychological assessment

including risk.

Professional ■ Skills in coordinating research teams

(supervisors, governance officers,

collaborators).

■ Experience t ra ining of other

professionals within the team.

■ Understanding of diversity values ethics

and integrity.

Strategic ■ Critiquing the literature and guidelines

regarding therapeutic interventions used

in service.

■ Ability to use evidence, data collection,

outcomes and audit to constructively

critique current service practice.

Clinical ■ Broad knowledge of different

therapeutic models that are used to

lead a client’s care.

■ Reflection an d awareness of systemic

issues operating within teams/able to

lead team dynamics discussions.

■ Encourage t e a m reflection on

current/innovative practice.

■ Psychological pe r spect ive on

multifarious health and mental health

presentations.

■ Ability to develop and operationalise

clinical and service outcome

evaluations.

Professional ■ Application o f different psychological

models to supervision and consultation

with other professionals.

■ Training other professionals in the

application of complex psychological

models.

■ Conflict m a n a g e m e n t skills.

■ Participate in and oversee research

projects.

Strategic ■ Able to construct and share service

development plans.

■ Influence organisational policies and

procedures.

Clinical ■ Ability to integrate psychological

knowledge to inform client care

pathways and service innovation.

■ Where problems occur-be able to

identify links between elements in the

organisational system and formulate

service solutions.

■ Advise directors/commissioners on

speciality clinical standards / skill mix /

safe evidence based clinical practice /

resources.

Professional ■ Able to inspire, supervise and develop

leadership in others using psychological

knowledge.

■ Reflect on other professionals’

Perception of psychology.

■ Identify and work with organisational

distress.

■ Strategic involvement in research.

Strategic ■ Able to assess psychological service

development ideas at different levels:

client, professional and organisational.

■ Skilled in developing strong working

relationships with other professionals -

service leads directors and

commissioners.

■ Setting the direction of relevant

organisational policy procedures.

Clinical ■ Ability to draw on broad body of

research & integrate psychological

knowledge across a range of specialties

using common themes to influence

health economy pathways of care.

■ Experience and in-depth psychological

understanding which informs judgement

when facilitating organisational/

National clinical credibility /respect

for profession.

■ Able to clinically appraise and quality

assure consultant level performance.

Professional ■ Able to influence professional practice

at national guideline and policy level.

■ Able to create opportunities at the most

senior levels of influence to market the

profession.

■ Political awareness and containment of

organisational distress.

Strategic ■ Able to assess and implement

psychological ideas at higher

organisational levels/health economy

wide/national/ professional and political.

■ Skilled at understanding dynamics of

relationships and developing

relationships at a board level e.g. health

economy wide/commissioners/political

and national levels as appropriate.

■ Able to set the service direction and

influence corporate strategy.



3.14 Expanding areas of demand for clinical psychology

A recent collaborative piece of work between the Information Services Division (ISD) of NHS National Services Scotland (NSS) and NHS Education for Scotland (NES)32 noted "recent years have seen an unparalleled demand for increased access to Applied Psychologists and Psychological Therapies. A demand from both patients and professionals has arisen due to the ever increasing evidence base for psychological interventions".

3.14.1 Cost-effectiveness

Clinical psychologists' training enables them to act as multi-modal rather than single modality therapists. However, their training enables them to function at various levels of work in the organisation.

A recent Briefing Paper from the British Psychological Society for commissioners33 highlights areas of good practice where clinical psychologists can offer cost-effective service delivery in terms of direct psychological interventions and supervision and management of other professions delivering psychological therapies. Clinical Psychologists' assessment, formulation and intervention skills help to ensure appropriate targeting of therapies and can assist teams in management of care in mental health and physical health settings.

3.14.2 Payment by Results and Care Clusters: Psychological components of care packages

Brechin & Heywood-Everett (2013)34 identify the psychological components of each care package within the national Mental Health Payment by Results (PbR) programme in relation to the20 individual care clusters which are differentiated in terms of presentation, severity and duration of care to specify the care package needed to meet the needs of service users; based on NICE recommendations and best evidence-based practice. This paper recommends a framework by which psychological work is defined and understood based on the type and level of skill required to deliver a particular psychological behaviour within each package of care. It primarily focuses on three levels of practice/intervention: generic intervention, condition specific intervention and complex interventions. This links to previous work on care packages and pathways35

3.14.2.1 Generic interventions

These interventions are targeted at populations of people (e.g. people with mental distress) where broad psychological principles from generic psychological theories are applicable to large groups of people. This level covers low intensity interventions within the IAPT framework.

3.14.2.2 Condition-specific interventions

This level of practice involves the application of specific psychological theories for the amelioration of specific conditions (e.g. cognitive therapy for depression), and encompasses manualised treatment approaches. This level covers the high intensity interventions with the IAPT framework.



3.14.2.3 Complex/Multi-modal interventions

This level of practice involves the application of theories which go beyond addressing a specific condition/diagnosis, and allow for a more detailed understanding of the personal meaning of experiences. Practitioners at this level may be working in an integrative approach, calling upon different theoretical perspectives as appropriate. This level of working is appropriate to step 4 work.

There are some limitations in the National Institute for Health and Clinical Excellence approach to reviewing evidence as many RCTs (Randomised Control Trials) exclude people with complex co-morbid conditions although these are frequently encountered in routine clinical work. Therapist competence and therapeutic alliance account for much of the variance in terms of treatment efficacy and the RCT threshold may exclude interventions and therapies based on more complex formulations36 which integrate relevant interpersonal, biological, social and cultural factors.

Service users should receive psychological interventions from practitioners who are suitably qualified, trained and supervised to deliver these interventions and there is a need to recognise the different levels of competency related to the delivery of psychological interventions. Indirect psychological work involving supervision and consultation to the multidisciplinary team needs to be valued and measured as clinical activity.

Clinical psychologists and well-placed to provide clinical leadership within the IAPT (Improving Access to Psychological Therapies) programme.

3.14.3 Clinical Health Psychology, Public Health and Prevention and Long Term Conditions

Many people with long-term physical health conditions also have psychological problems. These can lead to significantly poorer health outcomes and reduced quality of life.

People with long-term physical health conditions – the most frequent users of health care services – commonly experience mental health problems such as depression and anxiety, or dementia in the case of older people37. As a result of these co-morbid problems, the prognosis for their long-term condition and the quality of life they experience can both deteriorate markedly. In addition, the costs of providing care to this group of people are increased as a result of less effective self-care and other complicating factors related to poor psychological well being. People with long-term physical health conditions could also have mental health problems. These can lead to significantly poorer health outcomes and reduced quality of life. Costs to the health care system are also significant – by interacting with and exacerbating physical illness, co-morbid mental health problems raise total health care costs by at least 45 per cent for each person with a long-term condition and co-morbid mental health problem.

This suggests that between 12 per cent and 18 per cent of all NHS expenditure on long-term conditions is linked to poor mental health and psychological wellbeing – between £8 billion and £13 billion in England each year. The more conservative of these figures equates to around £1 in every £8 spent on long-term conditions



Prevention and the behavioural intervention units that are developing in Public Health are a government priority for behavioural clinical psychology targeting lifestyle issues such as smoking, stress exercise and obesity.

An increasing number of psychologists now work in cancer, diabetes, cardiovascular, and pain services helping to promote psychophysical recovery and adjustment.

For instance, Macmillan Cancer Research is funding a study to identify the increased need for clinical psychology input to provide NICE compliant psychological therapy and support for people with cancer/their carers and staff.

In addition, psychological therapy can be effective in primary care and other settings for people with psychosomatic and medically unexplained symptoms.

3.14.4 Neuropsychology

Neuropsychology services linked to the assessment and neuro-rehabilitation are areas of growth in demand for clinical psychologists.

3.14.5 Adult Mental Health

Clinical psychologists have had a long and valued presence in specialist and primary care mental health service but recent work expands their contribution in the management of severe mental health problems such as schizophrenia and bipolar disorder where family intervention and cognitive behavioural approaches to symptom management have a sound evidence base38

3.14.6 Improving Access to Psychological Therapies (IAPT)

The Improving Access to Psychological Therapies (IAPT) is set to expand with targets to reduce waiting times for access to psychological therapies. The remit has also expanded to include psychological therapy for people with long term conditions, psychosis and personality disorder and those in contact with the criminal justice system. Many psychologists are already employed in these services as high intensity practitioners and as supervisors and managers of psychological practice.

However, there is a need to ensure continuing provision for people with longer term complex needs who may need highly skilled multi-modal therapy approaches, often delivered by clinical psychology services.

3.14.7 Child and Adolescent Health

In addition to more traditional roles for psychologists in Child and Adolescent Mental Health Services, there are increasing opportunities in child physical health, special needs children and neuropsychology services and a growth in demand for clinical psychologists is noted in these areas.

3.14.8 Older Adults

Older people will increasingly form a larger proportion and typically may present with complex, longer term mental and physical health problems. Better access to crisis, home treatment and psychological therapies is required and more integrated working with primary and secondary care services39. Better care for people with dementia40 involves early identification and intervention to support the individual, families and



carers, with a need for skilled psychological assessment and design of multi-disciplinary care packages and increased need for training and support of staff in delivering psychologically informed care.

3.14.9 Intellectual Disabilities

Clinical psychologists have a long history in the assessment and development of services for people with intellectual disabilities and continue to play important roles in service innovation and management of services and working with Autism spectrum disorder across primary and secondary care is an expanding area.

3.14.10 Forensic Clinical Psychology

There has been a steady growth in demand for psychologists to work in forensic settings including low, medium and high secure mental health services but also within prisons and community criminal justice services such as liaison and diversion services41.

3.14.11 Organisational and Management

A number of clinical psychologists have moved into general management, service director and Board Director posts within NHS Trusts and private, independent and voluntary sector organisations where they have been able to influence policy implementation and service development at an organisational level where their grounding in scientific approaches to behaviour and attitude change can exert a positive influence on services.

3.14.12 Private, Independent and Voluntary/Third Sector

An increasing number of clinical psychologists are being employed within the private, independent and voluntary or "third" healthcare sector. At the moment around 15-20% of psychologists undertake some work in this area and this sector is likely to grow. However, there has been little or no scoping of current and future demand in this sector.

3.14.12.1 Applied psychology services

A number of leading psychologists42 are advocating for the development of applied psychology services incorporating the services of many types of practitioner psychologist (e.g. clinical, counselling, educational, forensic, and occupational) to improve the psychological health and wellbeing of individuals and organisations. Applied psychology services may be constituted as for-profit or not-for-profit entities capable of bidding for health, care and business contracts in the future. Increasingly, psychologists who have traditionally worked as singleton independent/private practitioners have been forming independent psychology companies with capacity to fulfil such contracts. Bernard Kat and Derek Mowbray are co-directors of the National Centre for Applied Psychology with the aim of promoting new working models and practices for applied psychologists with national networks.



4 METHODOLOGY

The methodology employed in this project is outlined below.

The DCP Workforce project has a number of strands:

1. Review of policy and best practice indicating current and future demand for clinical psychology services

o Consultation with psychology leads and key stakeholders through semi-structured interviews and conference events

o Selective review of literature and existing policy and practice guidance

2. Analysis and critique of UK central statistics regarding the clinical psychology workforce

o Liaison with Central data collection bodies in the 4 Nations

o Analysis of existing data

o Validation of data returns by regional psychology leads

3. Analysis of online survey of UK clinical psychologists

o Profiling of clinical psychologists by age, sex, ethnicity

o Pay/salary band and changes over last two years

o Main employer(s)

o Types of contract

o Hours of work

o Main specialities/areas of work

o Planned age of retirement

o Membership of BPS/DCP

o Thematic analysis of key issues for clinical psychology profession



5 HEALTH AND CARE PROFESSIONS COUNCIL DATA

The following graphs have been prepared from HCPC Registration data and detail which was provided for this project following a Freedom of Information (FOI) request.

The Figure below indicates the number of HCPC registered clinical psychologists broken down by age groups and gender.

5.1 Age and Gender breakdown of UK Clinical Psychologists

The two figures below indicate that around 80% of UK clinical psychologists are female, although in the older age brackets, the gender balance is somewhat more even, although women continue to predominate in all age groups.



Figure 5 Age and Sex Distribution of UK Clinical Psychologists

Figure 6 HCPC Gender breakdown of clinical psychologists

80% of HCPC registered clinical psychologists are female and 20% male.



Figure 7 Number of UK HCPC Registered Clinical Psychologists by age band

The modal age band for UK clinical psychologists is 35-39 years.

Figure 8 Percentage of HCPC UK Registered Clinical Psychologists in various age bands



5.2 HCPC Registered Clinical Psychologists by UK Health Authority Region

The following Figures indicate the number of UK clinical psychologists registered in various Health Authority Regions. However, for over 10% of UK HCPC clinical psychology registrants, no location is recorded which means that some caution is needed in interpreting geographical equity of provision.

Figure 9 HCPC Registered UK Clinical Psychologists by Health Authority/Region

Figure 10 % of UK HCPC Registered Clinical Psychologists by Health Authority/Region

Number and Percentage of UK HCPC registered clinical psychologists in England, Scotland, Wales and Northern Ireland.

Around 76% of UK clinical psychologists are based in England, 11% "no location given", 8% in Scotland, 3% in Wales and 2% in Northern Ireland.

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% of UK HCPC Registered Clinical Psychologists by Region



Figure 11 Number of HCPC registered UK Clinical Psychologists in England, Scotland, Wales and Northern Ireland

Figure 12 Number and percentage of UK Clinical Psychologists in England, Scotland, Wales and Northern Ireland



5.3 Number of clinical psychologists per 100,000 population for England, Scotland, Wales and Northern Ireland

The Table and Figure below indicate that England and Scotland have the highest number of w.t.e. clinical psychologists per 100,000 of population, with Wales and Northern Ireland less well-served.

Table 3 Number of Clinical Psychologists per 100,000 population of UK nations

Figure 13 Number of Clinical Psychologists per 100,000 of UK Nations

Population of Four Nations and average w.t.e. clinical psychologists per 100,000 population

Scotland Wales N.Ireland England Total UK Average

5295000 3063456 1820863 53012456 63191775

17.30 12.76 12.25 17.19 14.87

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HCPC Registration data: number of clinical psychologists per 100,000 of population in 4 UK Nations



6 NHS ENGLAND: CENTRAL INFORMATION

The central information was provided from the Health and Social Care Information Centre (HSCIC) following a Freedom of Information request. It represents a snapshot of the headcount of clinical psychologists as at December 2014.

This data refers only to clinical psychologists in England who are employed by the NHS rather than those clinical psychologists working in Local Authorities, third sector or independent sector organisations or who are self-employed in the private sector.

This data needs to be validated by local heads of services within the Health Education England Regions.

There are some problems in relation to other professions (e.g. counselling psychologists, psychological therapists) being assigned to qualified clinical psychology occupational codes. Overall, nationally, this leads to an over-estimate of the number of qualified clinical psychologists.

Parallel data sets are under review for Scotland, Wales and Northern Ireland.

It is important that heads of service liaise with workforce and HR leads in their Trusts to ensure more accurate baseline data and coding.

There is no central collation of information about the increasing number of psychologists working part-time or full-time in independent/private practice or with third sector/local authority organisations.

6.1 Age

The modal age for psychologists in England is slightly younger (30-34 year age band) compared to the HCPC data. This may reflect coding issues with a number of non-clinical psychologists being erroneously coded as qualified.

Table 4 Age breakdown of clinical psychologists in NHS Employment in England

Under 25 25 to 29 30 to 34 35 to 39 40 to 44 45 to 49 50 to 54 55 to 59 60 to 64 65 and over All staff

number 34 566 1878 1854 1496 1113 961 567 252 89 8810

% total 0.4 6.4 21.3 21.0 17.0 12.6 10.9 6.4 2.9 1.0 100.0



Figure 14 Percentage of clinical psychologists in various age bands: England NHS workforce

6.2 Gender

Table 5 Gender breakdown of clinical psychologists in NHS Employment in England

The NHS employment data for England indicates around 82% of the workforce are female.

6.3 Ethnicity

Table 6 Ethnic breakdown of clinical psychologists in England (NHS employment)

Around 88.2% of the clinical psychology workforce in England are of White ethnic origin, 2.1% mixed, 4.2% Asian, 1.4% Black, 0.3% Chinese, 0.9% Other and the remainder “Unknown”.

0.4

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%% of clinical psychologists in various age bands: England

NHS Workforce

White Mixed Asian or Asian BritishBlack or Black BritishChinese Other UnknownTotal ethnic minority groups All groups

Number 7774 182 367 127 27 80 249 9.18% 8810

% total 88.2 2.1 4.2 1.4 0.3 0.9 2.8 100.0

Male Female Total % Male % Female

1,614 7,196 8,810 18.3% 81.7%



Figure 15 Ethnic breakdown of clinical psychologists in NHS workforce in England

6.4 Number of clinical psychologists per HEE Region and per 100,000 population

The Table and Figure below indicate the headcount number of clinical psychologists and numbers of clinical psychologists per 100,000 of the population.

88.2

2.1 4.2 1.4 0.3 0.9 2.8

0.0

10.0

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

White Mixed Asian or Asian British

Black or Black British

Chinese Other Unknown

Ethnic breakdown of clinical psychologists in NHS Workforce in England



Table 7 Number of clinical psychologists per Health Education England Region and per 100,000 population

The above Table and Figures below estimate the number of psychologists per 100,000 head of population and it is evident that South, North Central and East London Health Education Regions have a significantly higher number of psychologists per head than other Regions. This may be reflective of the concentration of specialist services in the London area and/or more well-funded and established clinical psychology services in this area.

Population served by HEE Region

Headcount

clinical

psychologists

Clinical

psychologists/

100,000

Health Education East Midlands 4555000.00 448 9.84

Health Education Wessex 2800000.00 317 11.32

Health Education East of England 5800000.00 684 11.79

Health Education South West 5000000.00 629 12.58

Health Education Yorkshire and the Humber 5400000.00 725 13.43

Health Education Kent, Surrey and Sussex 4000000.00 547 13.68

Health Education West Midlands 5600000.00 824 14.71

Health Education Thames Valley 2300000.00 348 15.13

ALL ENGLAND 54555000.00 8847 16.22

Health Education North West London 3000000.00 500 16.67

Health Education North West 7000000.00 1206 17.23

Health Education North East 3000000.00 561 18.70

Health Education South London 3000000.00 899 29.97

Health Education North Central and East London 3100000.00 1159 37.39

TOTALS 54555000



Figure 16 Estimate of number of clinical psychologists per 100,000 by Health Education England Region

6.5 Number of clinical psychologists in England by AfC pay band

Figure 17 Distribution of clinical psychologists by Agenda for Change NHS Pay Band

The data regarding number of clinical psychologists in England clearly has some inaccuracies as no qualified clinical psychologists will be employed on lower bands (3-6), although trainee clinical psychologist are employed on AfC Band 6.

Nonetheless the modal pay band for qualified clinical psychologists is Band 8a (c. 34%) as the career grade with smaller proportions (<20%) at Band 8c and above (Consultant Grade).

9.8411.32 11.79 12.58 13.43 13.68 14.71 15.13 16.22 16.67 17.23

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nEstimate of no of clinical psychologists per 100,000 population by Health Education

Region



Figure 18 Percentage of clinical psychologists employed in various AfC Pay Bands

6.5.1 Workforce validation by Clinical Psychology NHS Trust Leads

Psychology leads in NHS Trusts were contacted by DCP Regional Branch Chairs to validate the workforce returns. Only 19 leads to date responded but overall, it would appear that there is an 11% over-estimation of the qualified clinical psychology workforce; although there is considerable variation between NHS Trusts.

Figure 19 Actual number of clinical psychologists (n = 19 validated returns) as % HSCIC December 2014 data

6.6 Number of clinical psychologists in England by AfC pay band by Health Education England Regions

The Table and Figures below indicate the number of clinical psychologists by AfC pay band for each of the Health Education Regions.

Some variation in overall numbers and relative proportions in various pay bands is evident between regions.

0.01% 0.38%1.43%

3.91%

25.66%

34.28%

15.76%

12.10%

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25.00%

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Band 3 Band 4 Band 5 Band 6 Band 7 Band 8a Band 8b Band 8c Band 8d Band 9 Unknown

% of clinical psychologists in various pay bands (NHS England)

100.0%

62.0%

162.5%

83.9%

100.0% 100.0%

112.0%

96.6% 100.0%

88.7%

100.0%94.0%

66.7%

102.0%

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0.0%

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120.0%

140.0%

160.0%

180.0%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Actual number of clinical psychologists in NHS Trusts as a % of HSCIC December 31st 2014 data (n= 19 workforce returns validated by psychology leads)



Figure 20 Distribution of clinical psychologists in England by AfC Pay Band by Health Education Regions

Table 8: Number of clinical psychologists by AfC pay band by Health Education Regions

-

50

100

150

200

250

300

350

400

450

Health Education East Midlands

Health Education East of England

Health Education Yorkshire and the

Humber

Health Education Wessex

Health Education Thames Valley

Health Education North West London

Health Education South London

Health Education North Central and

East London

Health Education Kent, Surrey and

Sussex

Health Education North East

Health Education North West

Health Education West Midlands

Health Education South West

Number and AfC banding of clinical psychologists by Health Education Regions

Band 3

Band 4

Band 5

Band 6

Band 7

Band 8a

Band 8b

Band 8c

Band 8d

Band 9

Unknown

Band 3 Band 4 Band 5 Band 6 Band 7 Band 8a Band 8b Band 8c Band 8d Band 9 Unknown Totals

Health Education East Midlands - - 2 9 70 172 100 63 34 3 14 467

Health Education East of England - 1 5 22 155 256 134 82 37 7 4 703

Health Education Yorkshire and the Humber - 1 7 79 170 234 95 91 45 8 2 732

Health Education Wessex - 6 4 17 86 110 41 40 20 1 - 325

Health Education Thames Valley - 6 2 4 94 110 54 69 18 6 1 364

Health Education North West London - 1 5 11 142 184 90 62 22 2 - 519

Health Education South London - 6 15 29 285 348 102 98 39 3 - 925

Health Education North Central and East London - - 14 38 411 373 207 109 38 11 1 1,202

Health Education Kent, Surrey and Sussex - - 4 9 130 220 105 62 33 6 1 570

Health Education North East - 5 19 7 127 202 65 94 52 4 - 575

Health Education North West - 8 38 82 302 418 170 142 65 8 4 1,237

Health Education West Midlands 1 - 3 25 185 278 174 112 53 10 - 841

Health Education South West - 1 12 19 193 221 94 78 24 3 10 655

TOTALS 1 35 130 351 2,350 3,126 1,431 1,102 480 72 37 9,115



6.6.1 Health Education East Midlands

Figure 21: Number of clinical psychologist by AfC pay band: East Midlands Region

Table 9: Pay Band of Clinical Psychologists by NHS Trusts: Health Education East Midlands Region



Figure 22: Health Education East Midlands: no of clinical psychologists by NHS Trust

6.6.2 Health Education East of England

Figure 23 Number of clinical psychologist by AfC pay band: Health Education East of England



Table 10 Number of Clinical Psychologists by AfC pay band by NHS Trusts: East of England Region

Figure 24 Overall number of clinical psychologists by AfC pay band: Health Education England

Band 3 Band 4 Band 5 Band 6 Band 7 Band 8a Band 8b Band 8c Band 8d Band 9 Unknown All staff

Basildon and Thurrock University Hospitals NHS Foundation Trust 0 0 0 1 0 1 0 0 0 0 0 2

Cambridge University Hospitals NHS Foundation Trust 0 0 0 0 4 2 1 2 0 0 0 9

Cambridgeshire and Peterborough NHS Foundation Trust 0 0 0 5 42 54 22 21 9 2 0 155

Cambridgeshire Community Services NHS Trust 0 0 2 2 1 5 1 1 0 0 0 12

Colchester Hospital University NHS Foundation Trust 0 0 0 0 0 0 2 0 0 0 0 2

East and North Hertfordshire NHS Trust 0 0 0 0 0 1 0 0 0 0 0 1

Hertfordshire Community NHS Trust 0 0 0 0 2 9 4 4 1 0 0 20

Hertfordshire Partnership University NHS Foundation Trust 0 0 0 10 32 27 23 10 6 1 0 109

Ipswich Hospital NHS Trust 0 0 0 1 1 0 0 1 0 0 0 3

Mid Essex Hospital Services NHS Trust 0 0 0 1 1 0 0 1 0 0 0 3

Norfolk and Norwich University Hospitals NHS Foundation Trust 0 0 0 0 0 5 1 4 0 0 0 10

Norfolk and Suffolk NHS Foundation Trust 0 1 0 0 14 54 37 14 8 0 3 131

Norfolk and Suffolk NHS Foundation Trust * 2 26 21 10 4 63

Norfolk Community Health and Care NHS Trust 0 0 0 1 12 11 3 2 0 0 0 29

Norfolk Community Health and Care NHS Trust 5 8 3 2 18

North Essex Partnership NHS Foundation Trust 0 0 3 0 26 19 16 7 5 3 0 79

Papworth Hospital NHS Foundation Trust 0 0 0 0 0 2 0 0 0 0 0 2

Queen Elizabeth Hospital King's Lynn NHS Foundation Trust 0 0 0 0 2 3 3 1 1 0 0 10

South Essex Partnership University NHS Foundation Trust 0 0 0 0 19 65 21 14 6 1 0 126

Southend University Hospital NHS Foundation Trust 0 0 0 0 0 0 0 0 0 0 1 1

West Hertfordshire Hospitals NHS Trust 0 0 0 0 0 1 0 0 1 0 0 2

West Suffolk NHS Foundation Trust 0 0 0 1 0 0 0 0 0 0 0 1

Health Education East of England totals 0 3 5 22 161 293 158 94 41 7 4 788

* not include Norfolk and cross specialty MDT



6.6.3 Health Education Kent, Surrey and Sussex

Figure 25: Number of clinical psychologists by AfC pay band: Health Education Kent, Surrey and Sussex

Table 11 Number of clinical psychologists by AfC pay band by NHS Trusts: Kent, Surrey and Sussex


Brighton and Sussex University Hospitals NHS Trust 0 0 0 0 0 1 0 0 2 0 0 3

East Kent Hospitals University NHS Foundation Trust 0 0 0 0 0 1 1 1 0 0 0 3

Kent and Medway NHS and Social Care Partnership Trust 0 0 0 1 29 40 27 14 9 2 0 122

Kent Community Health NHS Trust 0 0 0 0 0 2 2 0 0 0 0 4

Queen Victoria Hospital NHS Foundation Trust 0 0 0 0 0 1 0 0 0 0 0 1

Surrey and Borders Partnership NHS Foundation Trust 0 0 4 8 40 41 20 10 8 0 1 132

Surrey and Sussex Healthcare NHS Trust 0 0 0 0 0 1 0 0 0 0 0 1

Sussex Community NHS Trust 0 0 0 0 0 2 0 3 1 0 0 6

Sussex Community NHS Trust 1 1 2 4

Sussex Partnership NHS Foundation Trust 0 0 0 0 61 131 55 34 13 4 0 298

Western Sussex Hospitals NHS Foundation Trust 0 0 0 0 0 1 0 1 0 0 0 2

Health Education Kent, Surrey and Sussex 0 0 4 9 131 222 105 65 33 6 1 576



Figure 26 Number of clinical psychologists by AfC pay band by NHS Trusts: Kent, Surrey and Sussex

6.6.4 Health Education North East

Figure 27 Number of clinical psychologists by AfC pay band Health Education North East

519

7

127

203

66

94

52

4

0

50

100

150

200

250

Band 4 Band 5 Band 6 Band 7 Band 8a Band 8b Band 8c Band 8d Band 9

Health Education North East: no. of clinical psychologists: December 2014



Table 12 Number of clinical psychologists by AfC pay band by NHS Trusts: Health Education North East

Figure 28 Number of clinical psychologists by AfC pay band by NHS Trusts: Health Education North East

6.6.5 Health Education North West

Figure 29 Number of clinical psychologists by AfC pay band: Health Education North West


City Hospitals Sunderland NHS Foundation Trust 0 0 0 0 0 1 5 0 1 0 0 7

County Durham and Darlington NHS Foundation Trust 0 0 0 0 4 5 0 0 2 0 0 11

Newcastle Upon Tyne Hospitals NHS Foundation Trust 0 0 0 0 12 19 10 13 3 0 0 57

North Tees and Hartlepool NHS Foundation Trust 0 0 0 2 3 3 1 1 0 0 0 10

Northumberland, Tyne and Wear NHS Foundation Trust 0 4 4 3 43 61 28 34 27 2 0 206

Northumbria Healthcare NHS Foundation Trust 0 0 8 0 25 16 6 3 5 0 0 63

South Tees Hospitals NHS Foundation Trust 0 0 0 0 6 5 1 4 1 0 0 17

South Tyneside NHS Foundation Trust 0 0 6 0 0 0 0 0 0 0 0 6

Tees, Esk and Wear Valleys NHS Foundation Trust 0 1 1 2 34 93 15 39 13 2 0 200

Tees, Esk and Wear Valleys NHS Foundation Trust 1 39 93 15 44 11 1 204

Health Education North East Totals 0 5 19 8 166 296 81 138 63 5 0 781

0

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Health Education North East: no. of clinical psychologists: December 2014

Band 4

Band 5

Band 6

Band 7

Band 8a

Band 8b

Band 8c

Band 8d

Series9



Table 13: Number of clinical psychologists by AfC pay band by NHS Trusts: North West

8

38

82

304

419

170

142

66

8 4

-

50

100

150

200

250

300

350

400

450

Band 4 Band 5 Band 6 Band 7 Band 8a Band 8b Band 8c Band 8d Band 9 Unknown

Health Education North West: no. of clinical psychologists December 2014


5 Boroughs Partnership NHS Foundation Trust - - - 3 45 31 12 12 5 1 - 109

Aintree University Hospital NHS Foundation Trust - - - - - 1 - 1 - - - 2

Alder Hey Children's NHS Foundation Trust - - - - 10 18 6 4 - - - 38

Blackpool Teaching Hospitals NHS Foundation Trust - - 4 7 - 5 3 - 1 - - 20

Bolton NHS Foundation Trust - - 2 2 4 5 2 3 - - - 18

Bridgewater Community Healthcare NHS Foundation Trust - - - 1 4 - - 2 - - - 7

Calderstones Partnership NHS Foundation Trust - 1 - 3 2 4 1 2 2 - - 15

Central Manchester University Hospitals NHS Foundation Trust - 2 1 6 30 21 15 19 6 1 - 101

Cheshire and Wirral Partnership NHS Foundation Trust - - - 1 8 45 16 15 1 - 1 87

Clatterbridge Cancer Centre NHS Foundation Trust - - - - - 1 - - - - - 1

Countess of Chester Hospital NHS Foundation Trust - - - - 1 - - - - - - 1

Cumbria Partnership NHS Foundation Trust - - - 23 54 12 8 3 9 1 - 110

East Lancashire Hospitals NHS Trust - - - - - - 1 - - - - 1

Greater Manchester West Mental Health NHS Foundation Trust - 4 - 2 30 62 20 10 6 1 - 135

Lancashire Care NHS Foundation Trust - - 16 25 41 54 36 23 9 - - 204

Lancashire Teaching Hospitals NHS Foundation Trust - - - - 2 6 2 2 1 - - 13

Liverpool Heart and Chest Hospital NHS Foundation Trust - - - - - 1 - - - - - 1

Manchester Mental Health and Social Care Trust - 1 3 - 2 38 19 10 4 3 1 81

Mersey Care NHS Trust - - - - 11 42 9 10 11 - - 83

Mid Cheshire Hospitals NHS Foundation Trust - - - - - - - - 1 - - 1

Pennine Care NHS Foundation Trust - - 7 6 45 49 7 16 2 1 - 133

Pennine Care NHS Foundation Trust - 6 1 - 23 40 8 14 3 1 95

Royal Liverpool and Broadgreen University Hospitals NHS Trust - - - - 1 1 1 - 1 - - 4

Salford Royal NHS Foundation Trust - - 1 - 5 10 8 8 4 - - 36

Southport and Ormskirk Hospital NHS Trust - - - - 2 2 - 2 - - - 6

St Helens and Knowsley Hospitals NHS Trust - - - - 3 2 - - 1 - - 6

Stockport NHS Foundation Trust - - 3 - 3 3 - - - - - 9

University Hospital of South Manchester NHS Foundation Trust - - - 3 1 - - - - - - 4

Walton Centre NHS Foundation Trust - - - - - 6 4 - 2 - - 12

Wirral University Teaching Hospital NHS Foundation Trust - - - - - - - - - - 2 2

Wrightington, Wigan and Leigh NHS Foundation Trust - - 1 - - - - - - - - 1

Health Education North West - 14 39 82 327 459 178 156 69 9 4 1,336



Figure 30; Number of clinical psychologists by AfC pay band by NHS Trusts: North West

-

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n Tru

st

Health Education North West: no. of clinical psychologists December 2014

Band 4

Band 5

Band 6

Band 7

Band 8a

Band 8b

Band 8c

Band 8d

Band 9

Unknown



6.6.6 Health Education North West London

Figure 31: Number of clinical psychologists by AfC pay band: North West London

Table 14 Number of clinical psychologists by AfC pay band by NHS Trusts: North West London


Central and North West London NHS Foundation Trust 0 1 1 9 93 105 56 40 17 1 0 323

Central London Community Healthcare NHS Trust 0 0 0 0 5 8 2 0 2 0 0 17

Hounslow and Richmond Community Healthcare NHS Trust 0 0 1 0 3 3 0 0 0 0 0 7

London North West Healthcare NHS Trust 0 0 0 0 3 3 1 4 2 0 0 13

Royal Marsden NHS Foundation Trust 0 0 0 0 2 1 2 1 0 0 0 6

West London Mental Health NHS Trust 0 0 3 2 36 64 29 17 1 1 0 153

Health Education North West London Total 0 1 5 11 142 184 90 62 22 2 0 519



Figure 32 Number of clinical psychologists by AfC pay band by NHS Trusts: North West London

6.6.7 Health Education South London

Figure 33: Number of clinical psychologists by AfC pay band: South London



Table 15 Number of clinical psychologists by AfC pay band by NHS Trusts: South London

Figure 34 Number of clinical psychologists by AfC pay band by NHS Trusts: South London


Bromley Healthcare 0 0 0 0 0 2 0 0 0 0 0 2

Croydon Health Services NHS Trust 0 0 0 0 2 1 0 1 0 0 0 4

Epsom and St Helier University Hospitals NHS Trust 0 0 0 0 0 2 3 1 1 0 0 7

Guy's and St Thomas' NHS Foundation Trust 0 0 2 1 14 14 7 5 2 0 0 45

King's College Hospital NHS Foundation Trust 0 0 0 0 7 6 4 2 0 0 0 19

Kingston Hospital NHS Foundation Trust 0 0 0 0 2 2 0 0 1 0 0 5

Kingston Hospital NHS Foundation Trust 2 2 1 5

Lewisham and Greenwich NHS Trust 0 0 0 0 0 0 1 0 0 0 0 1

Oxleas NHS Foundation Trust 0 1 1 2 64 66 21 22 7 1 0 185

South London and Maudsley NHS Foundation Trust 0 3 12 23 160 165 38 56 18 1 0 476

South London and Maudsley NHS Foundation Trust 0 3 12 23 160 165 38 18 3 0 0 422

South West London and St George's Mental Health NHS Trust 0 0 0 3 31 68 25 10 6 1 0 144

St George's Healthcare NHS Trust 0 2 0 0 4 19 3 2 3 0 0 33

Your Healthcare 0 0 0 0 2 4 0 0 2 0 0 8

Health Education South London Totals 0 9 27 54 448 514 140 118 43 3 0 1356



6.6.8 Health Education North Central and East London

Figure 35 Number of clinical psychologists by AfC pay band: North, Central and East London

Table 16 Number of clinical psychologists by AfC pay band by NHS Trusts: North, Central and East London


Barking, Havering and Redbridge University Hospitals NHS Trust - - - - - - 1 - 1 - - 2

Barnet, Enfield and Haringey Mental Health NHS Trust - - - 3 44 49 32 18 4 2 - 152

Barts Health NHS Trust - - 2 - 9 14 9 4 1 - - 39

Camden and Islington NHS Foundation Trust - - - 7 84 70 20 8 8 2 - 199

Camden and Islington NHS Foundation Trust 5 87 62 16 7 8 2 187

East London NHS Foundation Trust - - - 8 59 71 33 20 5 2 - 198

Great Ormond Street Hospital For Children NHS Foundation Trust - - - - 22 15 32 8 6 - - 83

Homerton University Hospital NHS Foundation Trust - - - 4 39 15 11 6 1 - - 76

North East London NHS Foundation Trust - - 9 14 73 58 22 5 1 2 - 184

Royal Free London NHS Foundation Trust - - - - 10 14 6 5 1 - - 36

Tavistock and Portman NHS Foundation Trust - - - 1 28 15 12 24 2 2 - 84

University College London Hospitals NHS Foundation Trust - - 3 1 20 24 11 6 8 1 1 75

Whittington Hospital NHS Trust - - - - 30 31 19 5 - - - 85

Health Education North Central and East London Totals - - 14 43 505 438 224 116 46 13 1 1,400



Figure 36 Number of clinical psychologists by AfC pay band by NHS Trusts: North, Central and East London

6.6.9 Health Education South West

Figure 37 Number of clinical psychologists by AfC pay band: South West



Table 17 Number of clinical psychologists by AfC pay band by NHS Trusts: South West

Figure 38 Number of clinical psychologists by AfC pay band by NHS Trusts: South West


2Gether NHS Foundation Trust 0 0 0 0 13 27 19 4 7 1 0 71

2Gether NHS Foundation Trust 13 22 9 2 4 1 51

Avon and Wiltshire Mental Health Partnership NHS Trust revised 0 0 0 9 46 55 16 16 5 1 0 148

Avon and Wiltshire Mental Health Partnership NHS Trust revised 40 57 17 10 3 0 127

Bristol Community Health 0 0 0 0 0 0 0 0 0 0 8 8

Cornwall Partnership NHS Foundation Trust 0 0 0 2 10 24 6 6 1 0 2 51

Devon Partnership NHS Trust 0 0 0 1 34 25 20 9 2 0 0 91

Gloucestershire Hospitals NHS Foundation Trust 0 0 0 0 4 7 3 4 1 0 0 19

Great Western Hospitals NHS Foundation Trust 0 0 0 0 0 1 0 0 0 0 0 1

North Bristol NHS Trust 0 0 8 1 29 31 5 11 3 0 0 88

Northern Devon Healthcare NHS Trust 0 0 0 0 1 0 0 0 0 0 0 1

Plymouth Community Healthcare CIC 0 0 4 1 11 8 2 8 0 0 0 34

Plymouth Hospitals NHS Trust 0 1 0 0 8 4 3 1 0 0 0 17

Royal Cornwall Hospitals NHS Trust 0 0 0 0 1 1 2 1 1 0 0 6

Royal National Hospital For Rheumatic Diseases NHS Foundation Trust 0 0 0 0 6 1 1 2 0 0 0 10

Royal United Hospitals Bath NHS Foundation Trust 0 0 0 2 1 2 0 1 0 0 0 6

Somerset Partnership NHS Foundation Trust 0 0 0 2 22 17 12 11 3 0 0 67

South Devon Healthcare NHS Foundation Trust 0 0 0 1 5 10 2 2 0 1 0 21

Taunton and Somerset NHS Foundation Trust 0 0 0 0 1 1 0 1 0 0 0 3

Torbay and Southern Devon Health and Care NHS Trust 0 0 0 0 0 0 1 0 0 0 0 1

University Hospitals Bristol NHS Foundation Trust 0 0 0 0 1 8 2 1 1 0 0 13

Weston Area Health NHS Trust 0 0 0 0 3 1 0 0 0 0 0 4

Health Education South West 0 1 12 19 196 223 94 78 24 3 10 660

Virgin care Ltd (Devon ICS) 3 9 7 6 1 26



6.7 Health Education Thames Valley

Figure 39 Number of clinical psychologists by AfC pay band: Thames Valley

Table 18 number of clinical psychologists by AfC pay band by NHS Trusts: Thames Valley


Berkshire Healthcare NHS Foundation Trust - 5 1 1 27 45 23 12 9 1 - 124

Buckinghamshire Healthcare NHS Trust - - - - 5 6 4 3 2 2 - 22

Milton Keynes Hospital NHS Foundation Trust - - - - 1 - - - - - - 1

Oxford Health NHS Foundation Trust - 1 1 3 57 54 20 47 7 2 - 192

Oxford University Hospitals NHS Trust - - - - 5 7 7 8 1 1 - 29

Oxford University Hospitals NHS Trust 4 7 3 7 7 28

Royal Berkshire NHS Foundation Trust - - - - - - - - - - 1 1

Health Education Thames Valley - 6 6 4 102 115 61 77 19 6 1 397



Figure 40 Number of clinical psychologists by AfC pay band by NHS Trusts: Thames Valley

6.8 Health Education Wessex

Figure 41 Number of clinical psychologists by AfC pay band: Wessex



Table 19 Number of clinical psychologists by AfC pay band by NHS Trusts: Wessex

Figure 42 Number of clinical psychologists by AfC pay band by NHS Trusts: Wessex

6.9 Health Education West Midlands

Figure 43 Number of clinical psychologists by AfC pay band: West Midlands


Dorset County Hospital NHS Foundation Trust - - - - 1 1 - - - - - 2

Dorset Healthcare University NHS Foundation Trust - 3 1 - 23 29 10 8 9 1 - 84

Hampshire Hospitals NHS Foundation Trust - - - - 2 4 1 - 2 - - 9

Isle of Wight NHS Trust - - 1 - 1 7 1 3 1 - - 14

Poole Hospital NHS Foundation Trust - - - - 1 2 1 - - - - 4

Salisbury NHS Foundation Trust - 3 - 3 - 3 - - 1 - - 10

Solent NHS Trust - - 2 12 19 25 9 2 1 - - 70

Southern Health NHS Foundation Trust - - - 2 30 33 18 24 4 - - 111

University Hospital Southampton NHS Foundation Trust - - - - 9 6 1 3 2 - - 21

Health Education Wessex Totals - 6 4 17 86 110 41 40 20 1 - 325



Table 20 Number of clinical psychologists by AfC pay band by NHS Trusts: West Midlands


Birmingham and Solihull Mental Health NHS Foundation Trust 0 0 0 0 37 54 48 23 6 2 0 170

Birmingham Children's Hospital NHS Foundation Trust 0 0 1 10 28 13 9 4 6 1 0 72

Birmingham Community Healthcare NHS Trust 0 0 0 0 2 8 7 0 3 1 0 21

Birmingham Community Healthcare NHS Trust 1 4 10 7 1 3 26

Black Country Partnership NHS Foundation Trust 1 0 2 8 27 36 20 13 9 0 0 116

Black Country Partnership NHS Foundation Trust 0 0 0 22 30 16 10 9 87

Coventry and Warwickshire Partnership NHS Trust 0 0 0 3 29 58 33 20 5 0 0 148

Dudley and Walsall Mental Health Partnership NHS Trust 0 0 0 0 4 11 10 1 2 2 0 30

Dudley Group NHS Foundation Trust 0 0 0 0 1 0 0 0 0 0 0 1

Heart of England NHS Foundation Trust 0 0 0 0 3 2 5 2 1 1 0 14

North Staffordshire Combined Healthcare NHS Trust 0 0 0 1 14 21 7 12 4 0 0 59

Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust 0 0 0 0 2 0 0 0 1 0 0 3

Sandwell and West Birmingham Hospitals NHS Trust 0 0 0 0 0 2 0 0 0 0 0 2

Shropshire Community Health NHS Trust 0 0 0 0 3 2 4 2 1 0 0 12

Shropshire Community Health NHS Trust revised 3 2 3 2 1 11

South Staffordshire and Shropshire Healthcare NHS Foundation Trust 0 0 0 3 13 36 21 22 8 2 0 105

South Warwickshire NHS Foundation Trust 0 0 0 0 4 6 3 1 1 1 0 16

Staffordshire and Stoke on Trent Partnership NHS Trust 0 0 0 0 1 0 0 1 0 0 0 2

walsall Healthcare NHS Trust revised 0.2

Walsall Healthcare NHS Trust 0 0 0 0 2 3 0 1 1 0 0 7

Worcestershire Acute Hospitals NHS Trust 0 0 0 0 1 0 1 0 0 0 0 2

Worcestershire Health and Care NHS Trust 0 0 0 0 14 25 6 9 5 0 0 59

Wye Valley NHS Trust 0 0 0 0 0 1 1 1 0 0 0 3

Health Education West Midlands 1 0 3 25 185 278 175 112 53 10 0 842

Hereford (provided by 2 gether NHS Trust) 3 8 6 2 3 22



Figure 44 Number of clinical psychologists by AfC pay band by NHS Trusts: West Midlands

6.10 Health Education Yorkshire and Humber: number and bandings

Figure 45 Number of clinical psychologists by AfC pay band: Yorkshire and Humber

1 7

79

172

237

96 92

45

8 20

50

100

150

200

250

Band 4 Band 5 Band 6 Band 7 Band 8a Band 8b Band 8c Band 8d Band 9 Unknown

Health Education Yorkshire & Humber: no. of clinical psychologists



Table 21 Number of clinical psychologists by AfC pay band by NHS Trusts: Yorkshire and Humber

Figure 46 Number of clinical psychologists by AfC pay band by NHS Trusts: Yorkshire and Humber


Bradford District Care Trust 0 0 3 0 2 10 0 3 3 0 0 21

Bradford Teaching Hospitals NHS Foundation Trust 0 0 0 4 11 9 0 3 0 1 0 28

Care Plus Group 0 0 0 0 0 0 0 0 0 0 2 2

Harrogate and District NHS Foundation Trust 0 0 0 0 1 7 0 1 0 0 0 9

Hull and East Yorkshire Hospitals NHS Trust 0 0 0 1 1 0 1 2 0 0 0 5

Humber NHS Foundation Trust 0 0 0 0 18 23 9 10 1 1 0 62

Leeds and York Partnership NHS Foundation Trust 0 0 1 2 20 40 14 19 9 0 0 105

Leeds and York Partnership NHS Foundation Trust 0 2 1 0 12 27 14 15 7 0 78

Leeds Community Healthcare NHS Trust 0 0 0 0 3 3 4 6 0 0 0 16

Leeds Teaching Hospitals NHS Trust 0 0 2 57 18 20 5 4 6 1 0 113

Mid Yorkshire Hospitals NHS Trust 0 0 0 0 0 1 3 3 1 0 0 8

Mid Yorkshire Hospitals NHS Trust 4 1 2 5 1 13

Navigo 0 0 0 0 1 3 1 1 0 0 0 6

Northern Lincolnshire and Goole NHS Foundation Trust 0 0 0 0 4 2 0 1 0 0 0 7

Rotherham Doncaster and South Humber NHS Foundation Trust 0 0 0 1 15 16 6 2 3 0 0 43

Sheffield Children's NHS Foundation Trust 0 0 0 1 15 16 13 9 1 1 0 56

Sheffield Children's NHS Foundation Trust 0 11 15 13 6 1 1 47

Sheffield Health and Social Care NHS Foundation Trust 0 1 0 5 35 19 11 7 11 2 0 91

Sheffield Health and Social Care NHS Foundation Trust 0 0 41 19 11 7 11 2 0 91

Sheffield Teaching Hospitals NHS Foundation Trust 0 0 0 1 4 11 5 1 2 1 0 25

Sheffield Teaching Hospitals NHS Foundation Trust revised 5 13 4 3 2 1 28

South West Yorkshire Partnership NHS Foundation Trust 0 0 1 7 23 55 19 18 7 1 0 131

York Teaching Hospital NHS Foundation Trust 0 0 0 0 1 2 5 2 1 0 0 11

Health Education Yorkshire and the Humber Totals 0 3 8 79 245 312 140 128 67 12 2 996

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Health Education Yorkshire & Humber: no. of clinical psychologists

Band 4

Band 5

Band 6

Band 7

Band 8a

Band 8b

Band 8c

Band 8d

Band 9

Unknown



7 NHS SCOTLAND

Data on employment of clinical psychologists in Scotland is collected centrally and regularly updated in a series of reports concerned with workforce planning for psychology services in NHSScotland and is collaboration between the Information Services Division (ISD) of NHS National Services Scotland and NHS Education for Scotland (NES).

Table 22 Applied Psychology Workforce in Scotland: March 2015

The Table above indicates that as of 31/03/2015, there were 850 qualified clinical psychologists employed in Scotland – an increase of 55 posts since 31/03/2014.

7.1 Age

Table 23 Age profile of Psychology Staff employed in NHS Scotland as at 31st March 2015

Professional Group 31st March 2014 31st March 2015 Difference

All Applied Psychologists 852.0 916.0 64.0

Clinical Psychologist 795.0 850.0 55.0

Counselling Psychologist 39.0 47.0 8.0

Health Psychologist 11.0 13.0 2.0

Forensic Psychologist 7.0 6.0 -1.0

Neuropsychologist1 0.0 0.0 0.0

Other Clinical Staff 307.0 347.0 40.0

Graduate of the MSc Psychological Therapy in Primary Care269.0 75.0 6.0

Graduate of the MSc Applied Psychology for Children & Young People2 36.0 41.0 5.0

CBT Therapist 45.0 51.0 6.0

Other Therapist415.0 18.0 3.0

Counsellor 37.0 37.0 0.0

Psychology Assistant 77.0 96.0 19.0

Other3 28.0 30.0 2.0

Total: All Professional Groups 1159.0 1263.0 104.0

x Denotes a null value

31st March 2014 31st March 2015

Professional Group Total Under 25 25-29 30-34 35-39 40-44 45-49 50-54

All Applied Psychologists 916.0 1.0 38.0 204.0 215.0 183.0 119.0 75.0

Clinical Psychologist 850.0 1.0 33.0 195.0 207.0 169.0 109.0 69.0

Counselling Psychologist 47.0 0.0 4.0 7.0 6.0 8.0 8.0 6.0

Health Psychologist 13.0 0.0 1.0 2.0 2.0 3.0 1.0 0.0

Forensic Psychologist 6.0 0.0 0.0 0.0 0.0 3.0 1.0 0.0

Neuropsychologist1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other Clinical Staff 347.0 10.0 87.0 62.0 38.0 30.0 33.0 42.0

Graduate of the MSc Psychological Therapy in Primary Care2 75.0 1.0 14.0 26.0 13.0 9.0 6.0 4.0

Graduate of the MSc Applied Psychology for Children & Young People2 41.0 0.0 11.0 11.0 13.0 5.0 0.0 1.0

CBT Therapist 51.0 0.0 0.0 0.0 4.0 5.0 15.0 18.0

Other Therapist4 18.0 0.0 2.0 1.0 1.0 3.0 2.0 4.0

Counsellor 37.0 0.0 0.0 2.0 0.0 6.0 3.0 7.0

Psychology Assistant 96.0 9.0 59.0 20.0 6.0 0.0 2.0 0.0

Other3 30.0 0.0 2.0 2.0 1.0 2.0 5.0 8.0

Total: All Professional Groups 1263.0 11.0 125.0 266.0 253.0 213.0 152.0 117.0

1. During 2014, those individuals previously recorded as Neuropsychologists (n= 4 headcount as at 31st December 2013) have been aligned with those professional groups regulated by

the HCPC (Health and Care Professionals Council), and are thus now recorded as Clinical Psychologists (ie a headcount of n= 4 Neuropsychologists as at 31st December 2013 appear in the

data as at 31st March 2015 as Clinical Psychologists). Those Clinical Psychologists, who in addition to their D Clin Psych qualification hold a Stage II BPS Neuropsychology qualification

total a headcount of n=26 as at 31st March 2015. The breakdown by NHS Board is: Ayrshire&Arran n= 1; Dumfries&Galloway n=2; Fife n=2; Grampian n=4; Greater Glasgow&Clyde n=5;

Highland n=2; Lothian n=7; State Hospital n=1; Tayside n=2.



Figure 47 Age profile of Clinical Psychologists in NHS Scotland March 2014 and March 2015

The modal age group for clinical psychologists in Scotland is 35-39 years.

7.2 Gender

In Scotland, 85% of clinical psychologists are female and 15% male.

Table 24 Male Clinical Psychologists employed in NHS Scotland as at 31/03/3015

Total Under 25 25-29 30-34 35-39 40-44

March 2014 Clinical Psychologist for 31st March 2014795.00 0.00 30.00 187.00 190.00 161.00

March 2015 Clinical Psychologist for 31st March 2015850.00 1.00 33.00 195.00 207.00 169.00

Source: CPS Workforce Database

0.00

50.00

100.00

150.00

200.00

250.00

Under 25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60+

Head

co

unt/

Wte

Age

March 2014 March 2015



Table 25 Female Clinical Psychologists employed in NHS Scotland as at 31/03/2015

7.3 Ethnicity

The NHS Scotland data refers to all staff employed in psychological therapies rather than clinical psychologists alone.

Table 26 Ethnicity of staff employed in psychology services in NHS Scotland March 2015

Table 27 Ethnicity of staff employed in psychology services in NHS Scotland: March 2015

Headcount Wte.

Professional Group Total Part time Whole time Total Part time Whole time

All Applied Psychologists; 774 410 365 636.3 271.3 365.0

Clinical Psychologist 725 385 341 596.6 255.6 341.0

Counselling Psychologist 37 18 19 30.4 11.4 19.0

Health Psychologist 9 5 4 6.9 2.9 4.0

Forensic Psychologist 3 2 1 2.4 1.4 1.0

Neuropsychologist1 0 0 0 0.0 0.0 0.0

Other Clinical Staff; 283 101 182 244.2 62.2 182.0

Graduate of the MSc Psychological Therapy in Primary Care2 62 27 35 53.9 18.9 35.0

Graduate of the MSc Applied Psychology for Children & Young People2 39 7 32 36.3 4.3 32.0

CBT Therapist 34 15 19 29.7 10.7 19.0

Other Therapist4 12 3 9 10.0 1.0 9.0

Counsellor 29 17 12 20.9 8.9 12.0

Psychology Assistant 82 15 67 76.7 9.7 67.0

Other3 25 17 8 16.7 8.7 8.0

Total: All Professional Groups 1057 511 547 880.5 333.5 547.0

Female

Headcount wte

Scottish 748 632.76

Other British 250 206.19

Irish 54 50.76

Other White 89 75.40

MIXED Any Mixed Background 8 6.20

Indian 6 5.50

Pakistani 5 4.53

Bangladeshi 0 0.00

Chinese 3 2.90

Other Asian 1 0.60

Caribbean 0 0.00

African 1 0.60

Other Black 0 0.00

OTHER Other Ethnic Background 2 2.00

DATA NOT PROVIDED/NOT KNOWN Data not Provided/Not Known 35 25.61

Total 1202 1013.05

WHITE

ASIAN, ASIAN SCOTTISH, ASIAN BRITISH

BLACK, BLACK SCOTTISH, BLACK BRITISH

Ethnic Group

No. % total

White 1141 94.9%

Mixed 8 0.7%

Asian/Asian British 15 1.2%

Black/Black British 1 0.1%

Other 2 0.2%

Not given 35 2.9%

0.0%

Totals 1202 100.0%



Around 95% of the workforce in psychology services in NHS Scotland is of White ethnic origin.

7.4 Disability

Table 28 Staff employed in Psychology Services in NHS Scotland with declared disability

Around 2% of psychology services workforce reported a declared disability but some caution is needed as over 5% declined to provide this information.

1141

8 15 1 235

0

200

400

600

800

1000

1200

White Mixed Asian/Asian British Black/Black British Other Not given

Ethnicity of workforce in psychological therapies: NHS Scotland March 2015

Disability Headcount wte % total

Yes 24 17.57 2.00%

No 1093 926.67 90.93%

Declined 64 52.01 5.32%

Data not Provided 21 16.8 1.75%

Total 1202 1013.05 100.00%



7.5 Regional distribution of clinical psychology staff in Scotland

Table 29 Staff employed in Psychology Services by Region and Health Board NHS Scotland March 2015

Figure 48 Clinical psychology staff in Scotland by Regions (inc. Special Health Boards)

Professional Group Clinical Psychologist

No %total

Scotland 832 98.11%

EAST REGION 215 25.35%

NHS Borders 13 1.53%

NHS Fife 66 7.78%

NHS Lothian 137 16.16%

NORTH REGION 178 20.99%

NHS Grampian 72 8.49%

NHS Highland 32 3.77%

NHS Orkney 0 0.00%

NHS Shetland 0 0.00%

NHS Tayside 74 8.73%

NHS Western Isles 0 0.00%

WEST REGION 419 49.41%

NHS Ayrshire & Arran 51 6.01%

NHS Dumfries & Galloway 24 2.83%

NHS Greater Glasgow & Clyde 237 27.95%

NHS Lanarkshire 72 8.49%

NHS Forth Valley 36 4.25%

SPECIAL HEALTH BOARDS 36 4.25%

State Hospital 9 1.06%

NHS Education for Scotland 26 3.07%

National Waiting Times Centre 1 0.12%

Totals 848 100.00%



Figure 49 Percentage of clinical psychologists working in various Scottish Regions (inc. Special Health Boards)

Almost half the number of clinical psychologists are employed in West Scotland, followed by around 25% in East Scotland and 21% in North Region.

25.35%

20.99%

49.41%

4.25%

% of clinical psychologists by Regions (inc. Special Health Boards)

EAST REGION

NORTH REGION

WEST REGION

SPECIAL HEALTH BOARDS



7.6 Vacancies for clinical psychology (March 2015)

Table 30 Vacancies and posts under advertisement at 31/03/2015

Job Title Scotland

East

Region

NHS

Borders NHS Fife

NHS

Lothian

North

Region

NHS

Grampian

NHS

Highland

NHS

Orkney

NHS

Shetland

NHS

Tayside

NHS

Western

Isles

West

Region

NHS

Ayrshire

& Arran

SCO EAST B F S NORT N H R Z T W WEST A

All Applied Psychologists; 43.0 9.0 0.0 4.0 5.0 8.0 4.0 1.0 0.0 0.0 3.0 0.0 26.0 6.0

Clinical Psychologist 41.0 9.0 0.0 4.0 5.0 8.0 4.0 1.0 0.0 0.0 3.0 0.0 24.0 6.0

Counselling Psychologist 2.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 2.0 0.0

Health Psychologist 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other Clinical Staff; 16.0 5.0 0.0 4.0 1.0 4.0 1.0 0.0 0.0 0.0 3.0 0.0 7.0 2.0

Clinical Associate in Applied Psychology 4.0 3.0 0.0 3.0 0.0 1.0 0.0 0.0 0.0 0.0 1.0 0.0 0.0 0.0

Child & Adolescent Therapist 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

CBT Therapist 1.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.0 1.0

Counsellor 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Psychology Assistant 7.0 1.0 0.0 1.0 0.0 3.0 1.0 0.0 0.0 0.0 2.0 0.0 3.0 1.0

Other Therapist4 4.0 1.0 0.0 0.0 1.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 3.0 0.0

Other Clinical Staff3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Total 59.0 14.0 0.0 8.0 6.0 12.0 5.0 1.0 0.0 0.0 6.0 0.0 33.0 8.0

1. Please note that as at 31st March 2015 there w ere also 18.5 w te posts that w ere approved for recruitment but yet to be advertised.

DCP UK Workforce Project


7.7 Pay Band

Table 31 Pay band of staff employed in Psychology Services in NHS Scotland March 2015

Figure 50 Percentage of clinical psychologists in various AfC pay bands: NHS Scotland

Around 27% of clinical psychologists in Scotland are on AfC pay bands at 8c or above but the modal pay band for 42% is Band 8a.

7.8 Specialties and areas of work

Table 32 Clinical psychology staff employed in NHS Scotland Psychology Services as at 31/03 2015 by area of work and target age of patients seen.

Professional Group Total Band 9 Band 8d Band 8c Band 8b Band 8a Band 7 Band 6 Band 5

All Applied Psychologists; 916.0 12.0 48.0 181.0 158.0 396.0 138.0 10.0 0.0

Clinical Psychologist 850.0 11.0 46.0 175.0 147.0 370.0 118.0 10.0 0.0

Counselling Psychologist 47.0 1.0 0.0 5.0 5.0 20.0 16.0 0.0 0.0

Health Psychologist 13.0 0.0 1.0 1.0 3.0 4.0 4.0 0.0 0.0

Forensic Psychologist 6.0 0.0 1.0 0.0 3.0 2.0 0.0 0.0 0.0

Neuropsychologist1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0

Other Clinical Staff; 347.0 0.0 0.0 3.0 2.0 10.0 145.0 74.0 62.0

Graduate of the MSc Psychological Therapy in Primary Care2 75.0 0.0 0.0 0.0 0.0 1.0 68.0 5.0 1.0

Graduate of the MSc Applied Psychology for Children & Young People2 41.0 0.0 0.0 0.0 0.0 0.0 19.0 21.0 1.0

CBT Therapist 51.0 0.0 0.0 0.0 0.0 3.0 37.0 11.0 0.0

Other Therapist5 18.0 0.0 0.0 2.0 0.0 5.0 8.0 3.0 0.0

Counsellor 37.0 0.0 0.0 0.0 0.0 0.0 4.0 32.0 1.0

Psychology Assistant 96.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 54.0

Other3 30.0 0.0 0.0 1.0 2.0 1.0 9.0 2.0 5.00.0

Total: All Professional Groups 1263.0 12.0 48.0 184.0 160.0 406.0 283.0 84.0 62.0

1%

6%

21%

18%42%

12%

% of clinical psychologists in various AfC pay bands: NHS Scotland

Band 9

Band 8d

Band 8c

Band 8b

Band 8a

Band 7

Child Adult Older People Total

(0-19yrs) (20-64yrs) (65yrs +)

Totals 242.00 503.00 47.00 87.00 850.00

Mental Health 179.00 288.00 29.00 5.00 501.00

Learning Disabilities 36.00 56.00 0.00 6.00 98.00

Physical Health 47.00 79.00 2.00 22.00 150.00

Forensic 4.00 41.00 0.00 1.00 46.00

Neuropsychology 9.00 25.00 4.00 29.00 67.00

Alcohol and Substance Misuse 0.00 27.00 0.00 0.00 27.00

Other 30.00 59.00 30.00 33.00 152.00

Totals 242.00 503.00 47.00 87.00 850.00

Age Non

Specific



Table 33 w.t.e Clinical Psychologists employed in NHS Scotland by area of work and year

Figure 51 % of clinical psychologists in Scotland employed in various specialties

Around 60% of clinical psychologists in Scotland are employed in mental health, followed by physical health (c. 18%) and “other” (18%), learning disability (12%), neuropsychology (c. 8%), forensic (c. 5%) and alcohol/substance misuse (c. 3%).

Figure 52 Clinical psychology w.t.e. staff employed in various areas of work in NHS Scotland: March 2014 and March 2015

Area of Work 30th September 2010

wte

Difference

wte %

Difference

Totals 667.9 711.3 43.4 6.5%

Mental Health 344.3 370.5 26.2 7.6%

Learning Disabilities 63.8 61.7 -2.1 -3.3%

Physical Health 84.9 93.3 8.4 9.9%

Forensic 35.1 38.0 2.9 8.3%

Neuropsychology 41.4 45.3 3.9 9.4%

Alcohol and Substance Misuse 23.1 23.4 0.3 1.3%

Other 75.4 79.2 3.8 5.0%

Totals 667.9 711.3 43.4 6.5%

31st March 201531st March 2014

59.16%

12.00%17.57%

5.20% 7.92%3.09%

18.07%

0.00%

10.00%

20.00%

30.00%

40.00%

50.00%

60.00%

70.00%

Me

ntal H

ealth

Learn

ing D

isabilitie

s

Ph

ysical He

alth

Fore

nsic

Ne

uro

psych

olo

gy

Alco

ho

l and

Sub

stance

M

isuse

Oth

er

% of clinical psychologists in Scotland working in various specialties

Mar2014 Mar2015

Professional Group March 2014 March 2015

Mental Health 344.30 370.50

Learning Disabilities 63.80 61.70

Physical Health 84.90 93.30

Forensic 35.10 38.00

Neuropsychology 41.40 45.30

Alcohol and Substance Misuse 23.10 23.40

Other 75.40 79.20

Source: Clinical Psychology (CPS) Workforce Websystem

0 50 100 150 200 250 300 350 400

Mental Health


Physical Health

Forensic

Neuropsychology

Alcohol and Substance Misuse

Other

Whole Time Equivalent

March 2015

March 2014



The above Figure indicates some diminution of w.t.e. posts in mental health but some expansion in physical health, forensic, neuropsychology and “other work”.

7.9 Types of contract

Table 34 Staff employed in Psychology Services in NHS Scotland by type of contract

Figure 53 Percentage of clinical psychology staff on permanent employment contracts in NHS Scotland: March 2015

Around 90% of clinical psychologists are on permanent contracts, with the remainder on fixed term contracts.

7.10 NHS Education for Scotland Applied Psychology Workforce training

Table 35 Headcount in training in Applied Psychology in NHS Scotland as at 30th June 2015.

Training Course Headcount

Doctorate in Clinical Psychology1 183

MSc Psychological Therapy in Primary Care 21

MSc Applied Psychology of Children & Young People 15

BPS Stage 2 Qualification in Health Psychology 10

Total Number in Training 229

1. In order to meet strategic objectives, training is aligned to strategic priorities. Of this total of 183, as at 30th June 2015, 23 were Forensic aligned posts, 23 were aligned to Older People's services and 36 were CAMHS aligned posts, funded by the Scottish Government.

Total Permanent Staff % Permanent Staff

Mar2015SCO Mar 2015 1263.00 1131.00 0.90

Dec2014SCO Dec 2014 1253.00 1089.00 0.87

Sep2014SCO Sep 2014 1202.00 1055.00 0.88

Jun2014SCO Jun 2014 1184.00 1038.00 0.88

Mar2014SCO Mar 2014 1159.00 1010.00 0.87

Dec2013SCO Dec 2013 1126.00 991.00 0.88

Sep2013SCO Sep 2013 1082.00 965.00 0.89

Jun2013SCO Jun 2013 1109.00 975.00 0.88

Mar2013SCO Mar 2013 1102.00 974.00 0.88

dec2012SCO Dec 2012 1072.00 956.00 0.89

sep2012SCO Sep 2012 711.00 685.00 0.96

jun2012SCO Jun 2012 718.00 691.00 0.96

Mar2012SCO Mar 2012 714.00 683.00 0.96

Dec2011SCO Dec 2011 710.00 667.00 0.94

sep2011SCO Sep 2011 688.00 645.00 0.94

jun2011SCO Jun 2011 688.00 645.00 0.94

mar2011SCO Mar 2011 688.00 642.00 0.93

82% 84% 86% 88% 90% 92% 94% 96% 98%

Mar 2015Dec 2014Sep 2014Jun 2014Mar 2014Dec 2013Sep 2013Jun 2013Mar 2013Dec 2012Sep 2012Jun 2012Mar 2012Dec 2011Sep 2011Jun 2011Mar 2011

% staff on Permanent Contracts

Ce

ns

us



7.11 Retention in NHS Scotland and attrition rates: clinical psychology trainees in Scotland

Figure 54 High Retention Rate of Doctorate in Clinical Psychology Trainees in NHS Scotland held over time following course completion (2003-2015)

Table 36 Low Attrition Rate of Doctorate in Clinical Psychology Trainees.

Expected Year of Completion

% Failed to Complete

2006 2.3%

2007 0%

2008 0%

2009 0%

2010 3.6%

2011 1.6%

2012 1.9%

2013 2.6%

2014 1.7%



Figure 55 Headcount of D Clin Psych Graduates (2008-2014) employed in NHS Scotland Psychology Services by NHS Board.

7.12 Clinical psychology workforce supply over time: NHS Scotland (w.t.e and headcount)

Figure 56 NHS Scotland Clinical Psychology Workforce: Supply over time: w.t.e.



Figure 57 NHS Scotland Clinical Psychology Workforce: Supply over time: headcount.

Figure 58 NHS Scotland w.t.e Clinical Psychologists per 100,000 population as at 30th June 2015.

7.13 Clinical psychologists per 100,000 population: NHS Scotland

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

2001 31 21 22 22 25 24 23 24 23 22 23 24 24 24

2002 32 30 29 29 28 27 27 26 23 22 22 20 19 19

2003 31 1 23 22 25 24 23 20 21 20 21 20 20 20

2004 31 - 1 23 26 25 23 22 23 24 25 25 25 22

2005 30 - - - 28 28 28 27 27 24 21 23 24 24

2006 44 - - - 1 34 38 36 32 33 33 31 31 31

2007 44 - - - - 1 40 36 32 35 32 30 29 30

2008 57 - - - - - 5 49 47 46 45 45 45 45

2009 46 - - - - - - 5 36 33 31 33 31 33

2010 42 - - - - - - - 38 35 37 36 36 37

2011 54 - - - - - - - - 40 40 32 30 28

2012 42 - - - - - - - - - 31 32 30 30

2013 70 - - - - - - - - - - 33 55 55

2014 58 - - - - - - - - - - - 31 36

Total 612 52 75 96 133 163 207 245 302 334 361 384 399 434

Year Qualified Total OutputHeadcount in workforce

NHS Board 2003 2004 2005 2006 2007 2008 2009 2010 2011

Ayrshire & Arran 0 2 3 7 12 13 18 17 19

Borders 1 3 2 5 6 6 7 7 7

Dumfries & Galloway 0 0 0 0 0 1 4 6 6

Fife 5 8 10 15 16 22 21 22 28

Forth Valley 3 4 5 6 7 7 8 9 9

Grampian 4 6 9 12 13 20 24 24 27

Greater Glasgow & Clyde 21 26 34 46 57 71 75 85 89

Highland 1 2 3 5 4 5 8 9 10

Lanarkshire 4 6 4 5 10 14 18 21 32

Lothian 8 10 17 18 22 27 34 34 33

State Hospital 2 3 3 4 4 4 4 4 6

Tayside 3 5 6 10 12 17 24 27 30

Figure 14: Headcount of D Clin Psych Graduates (2001-2014) employed in NHSScotland Psychology Services (2003-2014).

Please note: That the island boards are not included in this histogram, please see details of services to the island boards in the psychology publication at Tab 'Services to the Island Boards.

0

100

200

300

400

500

600

700

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Mar 2015

He

adco

un

t

Year

Total Number Qualified Employed in NHSScotland Psychology Services

2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

2001 31 67.7% 71.0% 71.0% 80.6% 77.4% 74.2% 77.4% 74.2% 71.0% 74.2% 77.4% 77.4% 77.4%

2002 32 93.8% 90.6% 90.6% 87.5% 84.4% 84.4% 81.3% 71.9% 68.8% 68.8% 62.5% 59.4% 59.4%

2003 31 3.2% 74.2% 71.0% 80.6% 77.4% 74.2% 64.5% 67.7% 64.5% 67.7% 64.5% 64.5% 64.5%

2004 31 - 3.2% 74.2% 83.9% 80.6% 74.2% 71.0% 74.2% 77.4% 80.6% 80.6% 80.6% 71.0%

2005 30 - - - 93.3% 93.3% 93.3% 90.0% 90.0% 80.0% 70.0% 76.7% 80.0% 80.0%

2006 44 - - - 2.3% 77.3% 86.4% 81.8% 72.7% 75.0% 75.0% 70.5% 70.5% 70.5%

2007 44 - - - - 2.3% 90.9% 81.8% 72.7% 79.5% 72.7% 68.2% 65.9% 68.2%

2008 57 - - - - - 8.8% 86.0% 82.5% 80.7% 78.9% 78.9% 78.9% 78.9%

2009 46 - - - - - - 10.9% 78.3% 71.7% 67.4% 71.7% 67.4% 71.7%

2010 42 - - - - - - - 90.5% 83.3% 88.1% 85.7% 85.7% 88.1%

2011 54 - - - - - - - - 74.1% 74.1% 59.3% 55.6% 51.9%

2012 42 - - - - - - - - - 73.8% 76.2% 71.4% 71.4%

2013 70 - - - - - - - - - - 47.1% 78.6% 78.6%

2014 58 - - - - - - - - - - - 53.4% 62.1%

% by cumulative year

output612 82.5% 79.8% 76.8% 85.8% 81.9% 85.2% 81.7% 87.3% 75.6% 74.6% 69.3% 72.0% 70.9%

Year Qualified Total OutputPercentage(%) in workforce

A Ayrshire & Arran B Borders

Y Dumfries & Galloway F Fife

V Forth Valley N Grampian

G Greater Glasgow & Clyde H Highland

L Lanarkshire S Lothian

R Orkney Z Shetlands

T Tayside W Western Isles



8 NHS WALES

8.1 Age

Table 37 Number of clinical psychologists in various age bands by Health Board: Wales

The modal age band for clinical psychologists in NHS Wales is 30-34 years, with 18.4% of the workforce in this age band.

Figure 59 Percentage of clinical psychologists in various age bands: NHS Wales

8.2 Gender

83% of clinical psychologists in Wales are female and 17% male.

Table 38 Number of psychologists by gender: Health Boards in Wales

Health Board by Age Band - Headcount - Jan 2015

Trust Name Under 25 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 60 Over 60 Total

ABERTAWE BRO MORGANNWG UNIVERSITY LHB 2 8 10 11 17 6 9 4 2 69.00

ANEURIN BEVAN UNIVERSITY LHB 3 5 15 17 25 21 8 15 7 116.00

BETSI CADWALADR UNIVERSITY LHB 5 24 33 21 23 20 25 12 6 169.00

CARDIFF AND VALE UNIVERSITY LHB 32 34 19 17 20 20 21 10 173.00

CWM TAF UNIVERSITY LHB 2 10 7 3 7 7 2 38.00

HYWEL DDA UNIVERSITY LHB 1 5 15 6 7 4 9 6 2 55.00

POWYS TEACHING LHB 3 3 1 5 1 13.00

VELINDRE NHS TRUST 1 1 2.00

Grand Total 11 77 117 84 96 79 76 66 29 635.00

1.7

12.1

18.4

13.2

15.1

12.412.0

10.4

4.6

0.0

2.0

4.0

6.0

8.0

10.0

12.0

14.0

16.0

18.0

20.0

Under 25 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 60 Over 60

%

% of clinical psychologists in various age bands: NHS Wales

Health Board by Gender - Headcount - Jan 2015

Trust Name Female Male Total

ABERTAWE BRO MORGANNWG UNIVERSITY LHB 60 9 69

ANEURIN BEVAN UNIVERSITY LHB 97 19 116

BETSI CADWALADR UNIVERSITY LHB 135 34 169

CARDIFF AND VALE UNIVERSITY LHB 149 24 173

CWM TAF UNIVERSITY LHB 29 9 38

HYWEL DDA UNIVERSITY LHB 46 9 55

POWYS TEACHING LHB 10 3 13

VELINDRE NHS TRUST 2 2

Grand Total 528 107 635



8.3 Ethnicity

Table 39 Ethnic breakdown of clinical psychologists: NHS Wales

Of those whose ethnicity was recorded, over 98% of clinical psychologists in Wales were of White ethnic origin. However, no details were available for 99/635 of the workforce.

No. %

A White - British 327 51

B White - Irish 9 1

C White - Any other White background 43 7

C2 White Northern Irish 2 0

C3 White Unspecified 62 10

CA White English 26 4

CC White Welsh 49 8

CN White Gypsy/Romany 1 0

CX White Mixed 2 0

CY White Other European 4 1

F Mixed - White & Asian 2 0

G Mixed - Any other mixed background 2 0

H Asian or Asian British - Indian 1 0

J Asian or Asian British - Pakistani 1 0

M Black or Black British - Caribbean 1 0

No Record 52 8

R Chinese 1 0

S Any Other Ethnic Group 1 0

SA Vietnamese 1 0

SD Malaysian 1 0

Z Not Stated 47 7

Total 635 100



Figure 60 Ethnic breakdown of clinical psychologists in Wales

8.4 Number of clinical psychologists by AfC Pay Band: Health Boards in Wales – January 2015

Figure 61 Number of clinical psychologists by AfC Pay Band in Wales

51.5

1.4

6.8

0.3

9.8

4.1

7.7

0.2 0.3 0.6 0.3 0.3 0.2 0.2 0.2

8.2

0.2 0.2 0.2 0.2

7.4

0.0

10.0

20.0

30.0

40.0

50.0

60.0

A W

hite

-B

ritish

B W

hite

-Irish

C W

hite

-A

ny o

the

r Wh

ite b

ackgrou

nd

C2

Wh

ite N

orth

ern

Irish

C3

Wh

ite U

nsp

ecifie

d

CA

Wh

ite En

glish

CC

Wh

ite W

elsh

CN

Wh

ite G

ypsy/R

om

any

CX

Wh

ite M

ixed

CY W

hite

Oth

er Eu

rop

ean

F Mixe

d -

Wh

ite &

Asian

G M

ixed

-A

ny o

the

r mixe

d b

ackgrou

nd

H A

sian o

r Asian

British

-In

dian

J Asian

or A

sian B

ritish -

Pakistan

i

M B

lack or B

lack British

-C

aribb

ean

No

Re

cord

R C

hin

ese

S An

y Oth

er Eth

nic G

rou

p

SA V

ietn

ame

se

SD M

alaysian

Z No

t Stated

%Ethnic breakdown of clinical psychology workforce in Wales

19

29

140

86

145

84

91

33

8

0

20

40

60

80

100

120

140

160

Band 4 Band 5 Band 6 Band 7 Band 8a Band 8b Band 8c Band 8d Band 9

Wales: no. Of clinical psychologists by AfC Pay Band January 2015



The data on clinical psychologists in Wales would appear to have some inaccuracies – possibly related to the inclusion of Band 6 trainee clinical psychologists and other psychological therapies staff employed on Band 6 and miscoded as qualified clinical psychologists.

The modal pay band is Band 8a.

Table 40 Number of clinical psychologists in Wales by Health Board and by AfC Pay Band

Figure 62 Number of clinical psychologists in Wales by Health Board and AfC Pay Band

The Figure above indicates the distribution of clinical psychologists by various Health Boards and pay bands.

Health Board by Pay Band - Headcount - Jan 2015

Trust Name Band 4 Band 5 Band 6 Band 7 Band 8a Band 8b Band 8c Band 8d Band 9 Total

ABERTAWE BRO MORGANNWG UNIVERSITY LHB 2 7 3 9 26 9 8 5 69.00

ANEURIN BEVAN UNIVERSITY LHB 1 8 25 12 26 21 13 7 3 116.00

BETSI CADWALADR UNIVERSITY LHB 14 3 34 17 55 20 15 9 2 169.00

CARDIFF AND VALE UNIVERSITY LHB 2 4 76 21 15 17 29 7 2 173.00

CWM TAF UNIVERSITY LHB 1 11 6 9 8 2 1 38.00

HYWEL DDA UNIVERSITY LHB 6 2 14 12 8 12 1 55.00

POWYS TEACHING LHB 1 5 5 2 13.00

VELINDRE NHS TRUST 1 1 2.00

Grand Total 19 29 140 86 145 84 91 33 8 635

0

10

20

30

40

50

60

70

80

ABERTAWE BRO MORGANNWG

UNIVERSITY LHB

ANEURIN BEVAN UNIVERSITY LHB

BETSI CADWALADR UNIVERSITY LHB

CARDIFF AND VALE UNIVERSITY LHB

CWM TAF UNIVERSITY LHB

HYWEL DDA UNIVERSITY LHB

POWYS TEACHING LHB

VELINDRE NHS TRUST

Wales: no. Of clinical psychologists by Health Board: January 2015

Band 4

Band 5

Band 6

Band 7

Band 8a

Band 8b

Band 8c

Band 8d

Band 9



Figure 63 % of clinical psychologists in various pay bands: NHS\Wales January 2015

The above Figure excludes data on workforce below Band 6 and indicates that around 29% of the workforce are at Band 8c or above (Consultant grade) with 33 % at the “career grade” of Band 8a.

19%

33%

19%

20%

7%

2%

% of clinical psychologists in various pay band: NHS Wales January 2015

Band 7

Band 8a

Band 8b

Band 8c

Band 8d

Band 9



9 NHS NORTHERN IRELAND

Information on the clinical psychology workforce was supplied by Department of Health, Social Services and Public Safety (DHSSPS). However, the subsequent more detailed review of the clinical psychology workforce in Northern Ireland conducted by the DCP in Northern Ireland indicates that the central figure over-estimates by around the clinical psychology workforce 18% in terms of headcount. The DCP Northern Ireland figures were validated by Heads of Service.

9.1 DHSSPS data

9.1.1 Age

Table 41 Number and w.t.e. of clinical psychologists in various age bands: Northern Ireland

Headcount WTE %

25 - 29 53 50.9 15.3

30 - 34 72 68.7 20.8

35 - 39 71 62.4 20.5

40 - 44 59 53.4 17.1

45 - 49 38 34.8 11.0

50 - 54 27 23.7 7.8

55 - 59 19 16.1 5.5

60 - 64 2.0

65+ 0.0

TOTAL 346 316.4 100.0

5 year age bands

7 6.4



Figure 64 % of clinical psychologists in various age bands: Northern Ireland: DHSSPSS data

Figure 65 Number of clinical psychologists by NHS Trusts: Northern Ireland: DHSSPS data

9.1.2 Gender

Approximately 78% of the workforce is female.

15.3

20.8 20.5

17.1

11.0

7.8

5.5

2.0

0.00.0

5.0

10.0

15.0

20.0

25.0

25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65+

%% of clinical psychologists in various age bands:

Northern Ireland March 2015

106

67

52

42 44

35

0

20

40

60

80

100

120

Belfast Health and Social Care Trust

Northern Health and Social Care

Trust

South Eastern Health and Social

Care Trust

Southern Health and Social Care

Trust

Western Health and Social Care

Trust

HSC Board/Regional

Services

Northern Ireland: no. of clinical psychologists



Table 42 Number of clinical psychologists by gender: Northern Ireland (DHSSPS data)

Headcount WTE %

Gender Female 269 243.6 77.75%

Male 77 72.6 22.25%

Totals 346 100.00%

9.1.3 Number of clinical psychologists by AfC pay band: Northern Ireland

Table 43 Number and whole time equivalent of clinical psychologists in Northern Ireland (DHSSPS data)

Figure 66 Number of clinical psychologists by NHS Trust: Northern Ireland (DHSSPS data)

Headcount WTE

Belfast Health and Social Care Trust 106 95.6

Northern Health and Social Care Trust 67 61.7

South Eastern Health and Social Care Trust 52 44.9

Southern Health and Social Care Trust 42 37.6

Western Health and Social Care Trust 44 41.5

HSC Board/Regional Services 35 35

Totals 346 316.3

106

67

52

42 44

35

0

20

40

60

80

100

120

Belfast Health and Social Care Trust


Trust


Care Trust


Trust


Trust

HSC Board/Regional

Services

Northern Ireland: no. of clinical psychologists



Table 44 Number of clinical psychologists by AfC pay band: Northern Ireland

Figure 67 Number of clinical psychologists by AfC pay band: Northern Ireland: DHSSPS data

9.2 Division of Clinical Psychology: Northern Ireland data

9.2.1 Headcount and Pay Band of clinical psychologists

Table 45 Headcount and Pay Band of Clinical Psychologists in Northern Ireland: DCP data

Headcount WTE

Pay band 1 0 0

Pay band 2 0 0

Pay band 3 0 0

Pay band 4 18 16.9

Pay band 5 29 27.1

Pay band 6 45 44.6

Pay band 7 80 75.7

Pay band 8A 72 64.5

Pay band 8B 17 16

Pay band 8C 71 58.8

Pay band 8D

Pay band 9

Total 346

Payband

14 12.6

18

29

45

80

72

17

71

14

0

10

20

30

40

50

60

70

80

90

Pay band 4 Pay band 5 Pay band 6 Pay band 7 Pay band 8A

Pay band 8B

Pay band 8C

Pay band 8D

Pay band 9

Northern Ireland clinical psychologists by pay band



· Consultant (8C+) · Bands 8A – 8B · Band 7 Totals

Belfast Health and Social Care Trust 28 28 18 74

Northern Health and Social Care Trust 15 15 16 46

South Eastern Health and Social Care Trust 14 16 7 37

Southern Health and Social Care Trust 13 7 12 32

Western Health and Social Care Trust 14 12 9 35

Queens University Belfast 3 4 0 7

Totals 87 82 62 231

%Total 37.7% 35.5% 26.8% 100.0%



Figure 68 Headcount and Pay Band of Clinical Psychologists in Northern Ireland: DCP data

9.2.2 Specialties/areas of work

Figure 69 Main areas of specialty of clinical psychologists in Northern Ireland

28

1514

1314

3

28

1516

7

12

4

18

16

7

12

9

00

5

10

15

20

25

30

Belfast Health and Social Care

Trust


Trust


Care Trust


Trust


Trust

Queens University Belfast

Clinical psychologists AfC pay band by Health and Social Care Trusts (Northern Ireland - 2015)

Consultant (Band 8c+)

Bands 8a-8b

Band 7

Adult Mental Health / SMI 23%

Adult Physical Health 13%

Neuropsychology 6%

Learning Disability 16%

Child Mental Health 10%

Paediatrics / Disability 10%

Looked After Children 6%

Child ASD 4%

Adult ASD 3%

Older Adult / Stroke 4%

Forensic 2%

Addictions 1%

Training (QUB) 2%



Figure 70 Main areas of work of clinical psychologists in Northern Ireland

9.2.3 Vacancies and types of contract

Approximately one third of the workforce has part-time rather than full time employment contracts.

10 CLINICAL PSYCHOLOGY ONLINE SURVEY

The online survey of clinical psychologists achieved 4568 respondents, representing around 38% of the total of Health and Care Professions Council (HCPC) registered clinical psychologists.

The age, gender and ethnicity of respondents would appear representative of the NHS employees from Central Information (Section 2).

23%

13%

6%

16%

10% 10%

6%4%

3%4%

2%1%

2%

0%

5%

10%

15%

20%

25%

Ad

ult M

en

tal He

alth / SM

I

Ad

ult P

hysical H

ealth

Ne

uro

psych

olo

gy

Learn

ing D

isability

Ch

ild M

en

tal He

alth

Pae

diatrics / D

isability

Loo

ked

Afte

r Ch

ildre

n

Ch

ild A

SD

Ad

ult A

SD

Old

er A

du

lt / Stroke

Fore

nsic

Ad

dictio

ns

Trainin

g (QU

B)

Breakdown of clinical psychology staff by specialty: Northern Ireland January 2015

Vacancy Headcount WTE Full time Part time

Belfast Health and Social Care Trust 14.9 87 77.2 62 25

Northern Health and Social Care Trust 14.9 87 77.2 62 25

South Eastern Health and Social Care Trust 9 45 39.3 28 17

Southern Health and Social Care Trust 5 37 33.4 26 11

Western Health and Social Care Trust 6.9 37 32.3 25 14

Totals 50.7 293 259.4 203 92



10.1 Age

Figure 71 Age distribution of survey respondents

0

50

100

150

200

250

20 22 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 76 77

no

. of

re

spe

nd

en

ts

Respondent age

Age distribution of respondents to clinical psychology online survey (n= 4568)

326

485

910

848

803

553

423

236

132

48

10 20

100

200

300

400

500

600

700

800

900

1000

20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80 -84

No. Of clinical psychologist survey respondents in each age range



The average of clinical psychologists responding to the survey was 41.6 years (s.d. 9.7 years).

0%

1%

11%

20%

19%18%

12%

10%

5%3%

1%0% 0%

% of clinical psychologists in various age ranges (survey respondents)

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80 -84



10.1.1 Planned age of retirement

Table 46 Planned age of retirement

Over a third (37%) of respondents was unsure of their planned age of retirement. However, of those who responded 19.8 % planned to retire at 65, 18.3% at 60 and 5.3% at 55 years. A number of older clinical psychologists retain Mental Health Officer status which permits retirement at age 55 yeas with full pension benefits.

Figure 72Planned age of retirement of clinical psychologists (online survey)

Re sp o nse

Pe rce nt

Re sp o nse

Co unt

0.3% 13

0.0% 0

0.0% 1

0.1% 4

0.1% 4

5.3% 241

0.3% 15

0.8% 35

0.8% 37

0.3% 13

18.3% 830

0.3% 13

1.7% 75

1.4% 62

0.4% 20

19.8% 900

0.7% 31

4.9% 221

2.9% 133

0.1% 5

2.6% 120

0.0% 1

0.2% 10

0.0% 1

0.0% 1

1.2% 55

36.7% 1668

0.7% 31

4540

28

Not sure

55

68

75

sk ip p e d q ue stio n

58

71

50

63

72

51

64

Would rather not say

56

a nswe re d q ue stio n

57

70

Answe r Op tio ns

62

At wha t a g e d o yo u p la n to re tire ?

61

74

53

66

54

67

59

60

73

52

65

69



Most psychologists have not decided on an age of retirement.

Around 5% will retire at 55 years, just under 20% at age 60, and around 20% at age 65, with a smaller number (c. 10% intending to work between the ages of 65 and 70.

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

50

52

54

56

58

60

62

64

66

68

70

72

74

No

t …

At what age do you plan to retire? 50

51

52

53

54

55

56

57

58

59

60

61

62

63

64

65

66

67



Figure 73 Planned age of retirement: clinical psychologists over 50 years

10.2 Gender

79% of survey respondents were female which is representative of the gender breakdown of the clinical psychology profession.

Table 47 Gender of survey respondents

0 0

11

1 2 2 1

19

1 3 3

1

12

2 4

1 0 3

0 1 0 0 2

27

2

0

5

10

15

20

25

30

53

54

55

56

57

58

59

60

61

62

63

64

65

66

67

68

69

70

71

72

73

74

75

No

t sure

Wo

uld

rather n

ot say

pe

rce

nta

ge o

f sa

mp

le

Planned age of retirement for clinical psychologists aged 50 years and over (n =

951): online survey

Re sp o nse

Pe rce nt

Re sp o nse

Co unt

20.4% 925

79.0% 3584

0.3% 13

0.3% 13

4535

33

Ge nd e r

Prefer not to say

Male


Transgender

Answe r Op tio ns


Female



Figure 74 Gender of survey respondents

10.3 Ethnicity

Table 48 Ethnicity of survey respondents

20.4%

79.0%

0.3% 0.3%

Gender

Male

Female

Transgender

Prefer not to say



10.3.1 Ethnicity of survey respondents

The ethnicity of online survey respondents was representative of the ethnicity of NHS England and NHS Scotland clinical psychologists. Table 49 Ethnicity of survey respondents

Re sp o nse

Pe rce nt

Re sp o nse

Co unt

46.9% 2125

3.2% 147

6.0% 270

2.5% 114

20.0% 908

3.1% 140

0.0% 1

7.9% 357

0.2% 10

0.4% 16

0.9% 43

0.9% 41

1.5% 68

0.5% 24

0.4% 16

0.4% 20

0.7% 33

0.5% 22

0.7% 30

0.5% 24

0.6% 29

1.1% 52

1.0% 45

4535

33

Prefer not to say

White Welsh

Bangladeshi

Gypsy or Irish Traveller

Any other Black/African/Caribbean background

Ethnic ity

Any other Mixed/Multiple ethnic background

White and Black African


White Northern Irish

Any other Asian background

White and Black Caribbean

Any other ethnic group

White English

Pakistani

White Irish

Caribbean

African

White and Asian


White Scottish

Chinese

Any other White background

Arab

Answe r Op tio ns

Indian,

White British

White 4062

Mixed/Multiple Ethnic Groups 110

Asian/Asian British 161

Black/African/Caribbean/Black British 76

Other Ethnic Group 81

Prefer not to say/skipped question 78

Total 4568



Figure 75 Ethnicity of survey respondents

10.4 Employer(s)

Table 50 Percentage and number of clinical psychologists with main and subsidiary employers

Around 20% of respondents reported a second employer in addition to their main employer, suggesting an increasing trend for holding portfolio contracts with more than one organisation.

89%

2%

3% 2%2%

2%

Ethnicity of Clinical Psychology Online Survey Respondents

White

Mixed/Multiple Ethnic Groups

Asian/Asian British

Black/African/Caribbean/Black British

Other Ethnic Group

Prefer not to say/skipped question

Value FrequencyPercent Valid PercentCum Percent

Missing 109 2.39 2.39 2.39

Main employer 3577 78.31 78.31 80.69

Second employer 785 17.18 17.18 97.88

Third employer 84 1.84 1.84 99.72

Fourth employer 13 0.28 0.28 100

Totals 4568 100 100



10.5 Salary/pay band

Figure 76 Salary band(s) by main and subsidiary employers of clinical psychologists

Clinical psychologists with second or additional employers were often paid on other/non-NHS pay scales which is to be expected if the majority of this employment was within the independent sector. A number of clinical psychologists with additional employers had NHS contracts with other organisations with similar salary bands to their main employer.

3%

78%

17%

2% 0%

Survey respondents employer(s)

Missing

Main employer

Second employer

Third employer

Fourth employer

0

20

40

60

80

100

120

Main Second Third Fourth

%

Salary band by employer(s)

Other/Non NHS pay scale

Over Â£98,453

9 (c. Â£77,850-Â£98,453)

8d (c.Â£65,992-Â£81,619)

8c (c.Â£54,998-Â£67,805

8b (c. Â£45,707-Â£56,504)

8a (c. Â£39,239-Â£47,088)

7 (c. Â£30,764-Â£40,558)



Figure 77 Mean salary of clinical psychologists with main and subsidiary employers (pro-rata)

10.6 Changes in Pay Band: last 2 years

Table 51 Pay band now compared to 2 years ago

47030

51010

55221

42000

44000

46000

48000

50000

52000

54000

56000

Main Second Third

Me

an p

ro-r

ata

sala

ry £

Employer(s)

Mean salary (NB NHS scale data only)

Re sp o nse

Pe rce nt

Re sp o nse

Co unt

30.6% 1357

62.5% 2776

3.5% 156

3.4% 151

327

4440

128skip p e d q ue stio n

Yo ur p a y b a nd no w, a s co mp a re d to two ye a rs a g o is :

Lower as a result of a process not of my choice (e.g.

Higher


Lower, as a result of my choice

Answe r Op tio ns

Other (please specify)

The same



Figure 78 Pay band now compared to 2 years ago

Around 30% of psychologists reported they were on a higher pay band than two years ago but 63% remained on the same band. Around 3.5% were on a lower pay band through their own choice and another 3.5 % were on a lower band through re-structuring or down-banding.

10.7 Type of contract

10.7.1 Main employment contract

The majority of clinical psychologist respondents to the survey (c. 80%) were on permanent employment contracts. However, increasing numbers (c. 10% were on fixed term or interim/locum contracts and around 5% were fully self-employed.

Around 6% or survey respondents were in training in clinical psychology.

30.6%

62.5%

3.5%3.4%

Your pay band now, as compared to two years ago is:

Higher

The same

Lower, as a result of my choice

Lower as a result of a process not

of my choice (e.g. re-structure, re-

banding, re-deployment)

Main contract no. Respondents % of total

Fixed Term 312 8.9

Interim 36 1.0

Permanent 2810 79.7

Self-employed 158 4.5

Honorary contract 12 0.3

In training 197 5.6

TOTAL 3525



10.7.2 Overall types of employment contracts

Fixed Term, 8.9

Interim, 1.0

Permanent, 79.7

Self-employed, 4.5

Honorary contract,

0.3

In training, 5.6

Clinical psychologists: type of contract (% of total)

Fixed Term

Interim

Permanent

Self-employed

Honorary contract

In training

Fixed Term 10%

Interim/Locum 2%

In Training 5%

Permanent 70%

Self-employed 12%

Honorary contract

1%

Types of employment contract for clinical psychologists (online survey)

Fixed Term

Interim/Locum

In Training

Permanent

Self-employed

Honorary contract



Increasingly, clinical psychologists are working a portfolio career often involving a main and subsidiary employer. Taken overall, across all contracts, the numbers who are self-employed or on fixed term/locum contracts comprise a larger proportion overall.

10.8 Hours of work

Figure 79 Mean hours per week with main employer

Figure 80 Mean hours of clinical psychologists’ hours of work per week (all employers)

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

40.0

45.0

1 2 3 4 5 6 7 8

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

40

-45

46

-50

55

-60

Mo

re th

an 6

0

% o

f re

spo

nd

en

ts

hours per week

Mean hours per week worked by clinical psychologists (online survey n = 4568)

0.00

5.00

10.00

15.00

20.00

25.00

30.00

35.00

40.00

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 43 48 58 65

% o

f re

spo

nd

en

ts (

n=

45

68

)

hours per week

Clinical psychologists mean hours of work per week (all employers)



Table 52 Mean hours of work with main and subsidiary employers

A number of clinical psychologists are working part-time with their main employer (mean 29.9 hours). Mean hours with a second employer (for those 756 individuals who declared this) was 15.7 hours.

This pattern of work may become increasingly common for individuals who feel they are not obtaining career/pay progression in the NHS.

Figure 81 Percentage of clinical psychologists working with main and subsidiary employers

10.9 Main areas of work of UK Clinical Psychologists

Around 80% of UK clinical psychologists work in the following specialisms (in descending order)

Adult Mental Health

Child and Family


Clinical Health Psychology

Neuropsychology

Employer(s) N % Mean hours per week Std Dev

Main Employer 3960 82.4 29.9 14.1

Second Employer 756 15.7 10.3 6.8

Third Employer 77 1.6 6.2 3.9

Fourth Employer 13 0.3 6.9 5.1

TOTALS 4806 100.0

Main Employer - Hours per Week

82%

Second Employer -

Hours per Week

16%

Third Employer -Hours per Week

2%

Fourth Employer -Hours per Week

0%

Main Employer - Hours per Week

Second Employer - Hours per Week

Third Employer - Hours per Week

Fourth Employer - Hours per Week



Older Adults

Forensic

Paediatric psychology

Management



Figure 82 Number of sessions worked per specialty

10.9.1 Estimated number and % of HCPC clinical psychologists working in various specialties and estimated norms per 100,000 UK population

Table 53 Estimated number and percentage of UK HCPC registered clinical psychologists working in various specialties

0

200

400

600

800

1000

1200

1400

1600

1800

Ad

ult M

en

tal He

alth

Ch

ild an

d Fam

ily

Ne

uro

psych

olo

gy*

Clin

ical He

alth P

sycho

logy

Learn

ing D

isabilitie

s

Old

er A

du

lts

Teach

ing/Train

ing o

the

r pro

fessio

ns

Man

agem

en

t

Teach

ing/train

ing p

sycho

logists

Co

nsu

ltancy

Un

iversity/H

ighe

r Edu

cation

Pae

diatric p

sycho

logy

Oth

er (p

lease

de

scribe

be

low

)

Fore

nsic

Eating d

isord

ers

Ad

dictive

Difficu

lties

IAP

T-A

du

lt

Prim

ary Care

Me

ntal H

ealth

Pe

rinatal p

sycho

logy

HIV

/Sexu

al He

alth

Co

mm

ission

ing

Number of sessions worked per specialty: survey respondents

10

9

8

7

6

5

4

3

2

1



Psychologist w.t.e and % per

specialty

Specialty

Total

sessions(survey)

estmated w.t.e

(10 sessions)

Pro-rated

England

estimate nos

psychologists

% total HCPC

registered

psychologists

UK norms per

100,000

population

Addictive Difficulties 1484 148.4 367 3.25% 0.57

Adult Mental Health 9035 903.5 2234 19.78% 3.46

Child and Family 6258 625.8 1547 13.70% 2.40

Clinical Health Psychology 3755 375.5 928 8.22% 1.44

Commissioning 326 32.6 81 0.71% 0.12

Consultancy 438 43.8 108 0.96% 0.17

Eating disorders 58 5.8 14 0.13% 0.02

Forensic 1308 130.8 323 2.86% 0.50

HIV/Sexual Health 251 25.1 62 0.55% 0.10

IAPT- Adult 910 91 225 1.99% 0.35

Learning Disabilities 2271 227.1 561 4.97% 0.87

Management 2162 216.2 535 4.73% 0.83

Neuropsychology* 4600 460 1137 10.07% 1.76

Older Adults 2710 271 670 5.93% 1.04

Other (please describe below) 614 61.4 152 1.34% 0.23

Paediatric psychology 615 61.5 152 1.35% 0.24

Perinatal psychology 1341 134.1 332 2.94% 0.51

Primary Care Mental Health 857 85.7 212 1.88% 0.33

Teaching/Training other professions 1672 167.2 413 3.66% 0.64

Teaching/training psychologists 3681 368.1 910 8.06% 1.41

University/Higher Education 702 70.2 174 1.54% 0.27

Totals 45048 4504.8 11137 98.62%

online survey respondents 4568

Total HCPC registered psychologists 11888

Active UK HCPC registered

psychologists (assume 5% inactive) 11294

UK Population 2015 64,596,800.00



Figure 83 Estimated no. of UK clinical psychologists per specialty

Figure 84 Estimated percentage of UK psychologists per specialty

367

2234

1547

928

81 10814

323

62

225

561 535

1137

670

152 152

332

212

413

910

174

0

500

1000

1500

2000

2500

Ad

dictive

Difficu

lties

Ad

ult M

en

tal He

alth

Ch

ild an

d Fam

ily

Clin

ical He

alth P

sycho

logy

Co

mm

ission

ing

Co

nsu

ltancy

Eating d

isord

ers

Fore

nsic

HIV

/Sexu

al He

alth

IAP

T-A

du

lt

Learn

ing D

isabilitie

s

Man

agem

en

t

Ne

uro

psych

olo

gy*

Old

er A

du

lts

Oth

er (p

lease

de

scribe

be

low

)

Pae

diatric p

sycho

logy

Pe

rinatal p

sycho

logy

Prim

ary Care

Me

ntal H

ealth

Teach

ing/Train

ing o

the

r pro

fessio

ns

Teach

ing/train

ing p

sycho

logists

Un

iversity/H

ighe

r Edu

cation

Estimated no. Of UK Clinical Psychologists per specialty

19.78%

13.70%

4.97%

8.22%

10.07%

5.93%

2.86%1.35%

4.73%

1.34% 1.54%

8.06%

0.96%

3.66%

0.13%

1.99%3.25%

1.88%2.94%

0.55% 0.71%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

Ad

ult M

en

tal He

alth

Ch

ild an

d Fam

ily

Learn

ing D

isabilitie

s

Clin

ical He

alth P

sycho

logy

Ne

uro

psych

olo

gy*

Old

er A

du

lts

Fore

nsic

Pae

diatric p

sycho

logy

Man

agem

en

t

Oth

er (p

lease

de

scribe

be

low

)

Un

iversity/H

ighe

r Edu

cation

Teach

ing/train

ing p

sycho

logists

Co

nsu

ltancy

Teach

ing/Train

ing o

the

r pro

fessio

ns

Eating d

isord

ers

IAP

T-A

du

lt

Ad

dictive

Difficu

lties

Prim

ary Care

Me

ntal H

ealth

Pe

rinatal p

sycho

logy

HIV

/Sexu

al He

alth

Co

mm

ission

ing

Estimated % of total w.t.e. UK psychologists per specialty



Figure 85 Estimated w.t.e of UK clinical psychologists of UK population by specialty

Figure 86 Estimated percentage of UK clinical psychologists working in various sectors of care

Over half UK clinical psychologists work in secondary care, followed by around 25% in tertiary care, 13% in primary care and 10% in higher education.

0.57

3.46

2.40

1.44

0.12 0.170.02

0.50

0.100.35

0.87 0.83

1.76

1.04

0.23 0.240.51

0.33

0.64

1.41

0.27

0.00

0.50

1.00

1.50

2.00

2.50

3.00

3.50

4.00

Ad

dictive

Difficu

lties

Ad

ult M

en

tal He

alth

Ch

ild an

d Fam

ily

Clin

ical He

alth P

sycho

logy

Co

mm

ission

ing

Co

nsu

ltancy

Eating d

isord

ers

Fore

nsic

HIV

/Sexu

al He

alth

IAP

T-A

du

lt

Learn

ing D

isabilitie

s

Man

agem

en

t

Ne

uro

psych

olo

gy*

Old

er A

du

lts

Oth

er (p

lease

de

scribe

be

low

)

Pae

diatric p

sycho

logy

Pe

rinatal p

sycho

logy

Prim

ary Care

Me

ntal H

ealth

Teach

ing/Train

ing o

the

r p

rofe

ssion

s

Teach

ing/train

ing p

sycho

logists

Un

iversity/H

ighe

r Edu

cation

Estimated w.t.e. UK clinical psychologists per 100,000 of UK population by specialty

834, 13%

3253, 52%

1568, 25%

639, 10%

No. and % of UK clinical psychologists working in various sectors

Primary Care

Secondary Care (specialist e.g CMHT/Inpatient)

Tertiary Care (highly specialist e.g. Regional Service)

University/Higher Education



Figure 87 Clinical psychologists areas of specialty work by sector (primary, secondary, tertiary or university

10.9.2 Addictions

Table 54 Number of clinical psychologists working with addictive difficulties: sessions per week

It is estimated that around 3.7% of UK clinical psychologists work some session in services for people with addictive difficulties.

0

100

200

300

400

500

600

700

800

900

1000

Ad

dictive

Difficu

lties

Ad

ult M

en

tal He

alth

Ch

ild an

d Fam

ily

Clin

ical He

alth P

sycho

logy

Co

mm

ission

ing

Co

nsu

ltancy

Eating d

isord

ers

Fore

nsic

HIV

/Sexu

al He

alth

IAP

T-A

du

lt

Learn

ing D

isabilitie

s

Man

agem

en

t

Ne

uro

psych

olo

gy*

Old

er A

du

lts

Oth

er (p

lease

de

scribe

be

low

)

Pae

diatric p

sycho

logy

Pe

rinatal p

sycho

logy

Prim

ary Care

Me

ntal H

ealth

Teach

ing/Train

ing o

the

r pro

fessio

ns

Teach

ing/train

ing p

sycho

logists

Un

iversity/H

ighe

r Edu

cation

Clinical psychology specialties by sector

Primary care

Secondary Care

Tertiary care

University/Higher Education

No. of clinical psychologists working in addictive difficulties

sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 40 19 10 5 7 8 4 8 2 27 130

Second Employer 12 3 3 2 2 4 0 2 0 1 29

Third Employer 4 1 1 0 0 1 0 1 0 1 9

Fourth Employer 0 0 0 0 0 0 0 0 0 1 1

Totals (from online survey) 56 23 14 7 9 13 4 11 2 30 169

Estimated no. of UK clinical

psychologists working sessions in

addictive difficulties 139 57 35 17 22 32 10 27 5 74 418

Estimated % of total sessions/week

in addictive difficulties: UK 33% 14% 8% 4% 5% 8% 2% 7% 1% 18% 100%

Estimated no.UK

psychologists/100,000 population

working sessions in addictive

difficulties 0.65

Estimated % of total UK clinical


addictive difficulties 3.70%



Table 55 Total sessions per week for clinical psychologists working with addictive difficulties

Sessions worked in addiction services constitute around 1.3% of total sessions (w.t.e.) of UK clinical psychology services.

Figure 88 Estimated no. of UK clinical psychologists working with addictive difficulties by sessions per week

Figure 89 Estimated percentage of UK working with addictive difficulties by sessions per week

Sessions/week of clinical psychology for addictive difficulties

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 40 38 30 20 35 48 28 64 18 270 591

Second Employer 12 6 9 8 10 24 0 16 0 10 95

Third Employer 4 2 3 0 0 6 0 8 0 10 33

Fourth Employer 0 0 0 0 0 0 0 0 0 10 10


UK Estimated sessions in addictive

difficulties/week 139 114 104 69 111 193 69 218 45 742 1804

Estimated w.t.e of UK clinical

psychologists working in addictive

difficulties 12 10 9 6 9 16 6 18 4 62 151

Estimated % w.t.e of UK clinical

psychologists working in a addictive

difficulties 1.33%

Estimated w.t.e. UK


working in addictive difficulties 0.24

139

57

3517 22

32

1027

5

74

0

20

40

60

80

100

120

140

160

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in addictive difficulties



The majority of clinical psychologists working with addictive difficulties report only one session per week for this work. Only 18% work full-time in this specialty.

Figure 90 Estimated total clinical psychology sessions per week in addictive difficulties

Figure 91 Estimated headcount and w.t.e. of UK clinical psychologists working in addictive difficulties

33%

14%

8%

4%5%

8%

2%

7%

1%

18%

0%

5%

10%

15%

20%

25%

30%

35%

1 2 3 4 5 6 7 8 9 10

% o

f to

tal s

ess

ion

s in

ad

dic

tive

dif

ficu

ltie

s

sessions per week

Estimated % of total UK clinical psychologists working in addictive difficulties by sessions per week

139114 104

69

111

193

69

218

45

742

0

100

200

300

400

500

600

700

800

1 2 3 4 5 6 7 8 9 10

no

.

sessions per week

Estimated total clinical psychology sessions/week in addictive difficulties: UK



10.9.3 Adult IAPT services

Table 56 Number of UK clinical psychologists working in adult IAPT services

Around 3.3% of UK clinical psychologists work in adult IAPT services.

Table 57 No. of clinical psychology sessions per week in adult IAPT

139

57

35

1722

32

10

27

5

74

12 10 96

916

6

18

4

62

0

20

40

60

80

100

120

140

160

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e of UK clinical psychologists working in addictive difficulties

Estimated no. of UK clinical psychologists working sessions in addictive difficulties

Estimated w.t.e of UK clinical psychologists working in addictive difficulties

No. of clinical psychologists working in adult IAPT

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 21 16 4 9 15 15 5 5 6 22 118

Second Employer 5 4 0 2 4 4 1 3 2 4 29

Third Employer 2 0 0 0 0 0 0 0 0 0 2

Fourth Employer 1 0 0 0 0 0 0 0 0 0 1




adult IAPT services 72 49 10 27 47 47 15 20 20 64 371

Estimated % of total sessions/week

in adult IAPT: UK 19% 13% 3% 7% 13% 13% 4% 5% 5% 17% 100%

Estimated no.UK


working sessions in adult IAPT

services 0.58



adult IAPT services 3.28%



Sessions worked in adult IAPT services constitute around 1.4% of total sessions (w.t.e.) of UK clinical psychology services.

Figure 92 Estimated no. of UK clinical psychologists working in adult IAPT services

Figure 93 Estimated percentage of UK clinical psychologists working in adult IAPT services by sessions/week

The percentage of UK clinical psychologists working sessions per week in adult IAPT is relatively evenly spread with about 20% working 1-2 sessions, 16% working 5-6 sessions and 17% full time.

Figure 94 Estimated total clinical psychology sessions per week in adult IAPT

Sessions/week of clinical psychology in adult IAPT services

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 21 32 12 36 75 90 35 40 54 220 615

Second Employer 5 8 0 8 20 24 7 24 18 40 154

Third Employer 2 0 0 0 0 0 0 0 0 0 2

Fourth Employer 1 0 0 0 0 0 0 0 0 0 1


UK Estimated sessions in adult

IAPT/week 72 99 30 109 235 282 104 158 178 643 1911


psychologists working in adult IAPT 6 8 2 9 20 24 9 13 15 54 160


psychologists working in adult IAPT 1.41%

Estimated w.t.e. UK


working in adult IAPT 0.25

72

49

10

27

47 47

1520 20

64

0

10

20

30

40

50

60

70

80

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in adult IAPT services

19%

13%

3%

7%

13% 13%

4%5% 5%

17%

0%

5%

10%

15%

20%

25%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in adult IAPT by sessions per week



Figure 95 Estimated headcount and w.t.e of UK clinical psychologists working in adult IAPT

7299

30

109

235282

104

158178

643

0

100

200

300

400

500

600

700

1 2 3 4 5 6 7 8 9 10

no

. se

ssio

ns

sessions per week

Estimated sessions in adult IAPT/week: UK

72

49

10

27

47 47

1520 20

64

6 82

9

2024

913 15

54

0

10

20

30

40

50

60

70

80

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e. of UK clinical psychologists working in Adult IAPT

Estimated no. of UK clinical psychologists working sessions in adult IAPT services

Estimated w.t.e of UK clinical psychologists working in adult IAPT



10.10 Adult Mental Health

Table 58Number of UK clinical psychologists working in adult mental health

Around 41% of UK clinical psychologists work in adult mental health.

Table 59 Clinical psychology sessions per week in adult mental health

Sessions worked in adult mental health services constitute around 19% of total sessions (w.t.e.) of UK clinical psychology services.

No. of clinical psychologists working in adult mental health

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 188 130 102 140 157 194 88 160 58 316 1533

Second Employer 58 40 19 25 30 37 12 28 5 43 297

Third Employer 11 7 2 5 5 6 2 3 0 2 43

Fourth Employer 2 1 0 1 2 0 0 0 0 0 6


Estimated no. of UK clinical psychologists working sessions

in adult mental health 641 441 304 423 480 587 252 473 156 893 4650

Estimated % of total sessions/week in adult mental health:

UK 14% 9% 7% 9% 10% 13% 5% 10% 3% 19% 100%

Estimated no.UK psychologists/100,000 population working

sessions in adult mental health services 7.25

Estimated % of total UK clinical psychologists working

sessions in adult mental health services 41.1%

Sessions/week of clinical psychology in adult mental health services

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 188 260 306 560 785 1164 616 1280 522 3160 8841

Second Employer 58 80 57 100 150 222 84 224 45 430 1450

Third Employer 11 14 6 20 25 36 14 24 0 20 170

Fourth Employer 2 2 0 4 10 0 0 0 0 0 18


UK Estimated sessions in adult mental health/week 641 881 913 1693 2401 3519 1767 3782 1403 8934 25934

Estimated w.t.e of UK clinical psychologists working in

adult mental health 54 74 76 141 201 294 148 316 117 746 2167

Estimated % w.t.e of UK clinical psychologists working in

adult mental health 19.17%

Estimated w.t.e. UK psychologists/100,000 population

working in adult mental health 3.38



Figure 96 Estimated no. of UK clinical psychologists working in adult mental health

Figure 97 Estimated percentage of clinical psychologists working in adult mental health by sessions/week

The number of sessions/week worked in adult mental health per week is fairly evenly spread, with 19% or respondents working full time.

Figure 98 Estimated total clinical psychology sessions per week in adult mental health

641

441

304

423480

587

252

473

156

893

0

200

400

600

800

1000

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in adult mental health

14%

9%

7%

9%10%

13%

5%

10%

3%

19%

0%

5%

10%

15%

20%

25%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in adult mental health by sessions/week

641 881 913

16932401

3519

1767

3782

1403

8934

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

10000

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

UK Estimated sessions in adult mental health/week



Figure 99 Estimated headcount and w.t.e. of UK clinical psychologists working in adult mental health

10.11 Child and Family

Table 60 No. of clinical psychologists working in child and family services

Approximately 30% of UK clinical psychologists work some sessions in child and family services.

Table 61 No. of clinical psychology sessions/week in child and family services

Sessions worked in child and family services constitute around 13.7% of total sessions (w.t.e.) of UK clinical psychology services.

641

441

304

423480

587

252

473

156

893

54 74 76141

201

294

148

316

117

746

0

100

200

300

400

500

600

700

800

900

1000

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e of UK clinical psychologists working in adult mental health

Estimated no. of UK clinical psychologists working sessions in adult mental health

Estimated w.t.e of UK clinical psychologists working in adult mental health

No. of clinical psychologists working in child and family

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 118 103 86 109 114 162 55 109 34 206 1096

Second Employer 28 34 23 35 26 31 14 22 7 25 245

Third Employer 5 2 1 5 0 3 1 0 1 2 20

Fourth Employer 0 0 0 0 0 0 1 0 1 0 2


Estimated no. of UK clinical psychologists working

sessions in child and family 374 344 272 369 346 485 176 324 106 577 3373

Estimated % of total sessions/week in child and

family UK 11% 10% 8% 11% 10% 14% 5% 10% 3% 17% 100%

Estimated no.UK psychologists/100,000 population

working sessions in child and family 5.26

Estimated % of total UK clinical psychologists working

sessions in child and family 29.84%

Sessions/week of clinical psychology in child and family

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 118 206 258 436 570 972 385 872 306 2060 6183

Second Employer 28 68 69 140 130 186 98 176 63 250 1208

Third Employer 5 4 3 20 0 18 7 0 9 20 86

Fourth Employer 0 0 0 0 0 0 7 0 9 0 16


UK Estimated sessions in child and family/week 374 688 817 1475 1732 2910 1230 2594 958 5766 18544

Estimated w.t.e of UK clinical psychologists working

in child and family 31 57 68 123 145 243 103 217 80 482 1549

Estimated % w.t.e of UK clinical psychologists

working in child and family 13.70%

Estimated w.t.e. UK psychologists/100,000 population

working in child and family 2.42



Figure 100 Estimated no. of UK clinical psychologists working in child and family services

Figure 101 Estimated percentage of UK clinical psychologists working in child and family services by sessions/week

There is a fairly even spread of sessions/week worked in child and family services with the highest number of respondents (17%) working full time.

Figure 102 Estimated total no.of sessions per week in child and family services

374344

272

369346

485

176

324

106

577

0

100

200

300

400

500

600

700

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in child and family services

11%10%

8%

11%10%

14%

5%

10%

3%

17%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in child and family services by sessions/week

374688 817

14751732

2910

1230

2594

958

5766

0

1000

2000

3000

4000

5000

6000

7000

1 2 3 4 5 6 7 8 9 10

sess

op

ms

sessions per week

UK estimated no. of total sessions/week in child and family services



Figure 103 Estimated headcount and w.t.e. of UK clinical psychologists working in child and family services

10.12 Clinical Health Services

Table 62 No. of clinical psychologists working in clinical health services

Approximately 18% of UK clinical psychologists are working in clinical health services.

374344

272

369346

485

176

324

106

577

3157 68

123145

243

103

217

80

482

0

100

200

300

400

500

600

700

1 2 3 4 5 6 7 8 9 10

Axis Title

Estimated headcount and w.t.e. of UK clinical psychologists working in child and family services

Estimated no. of UK clinical psychologists working sessions in child and family

Estimated w.t.e of UK clinical psychologists working in child and family

No. of clinical psychologists working in clinical health psychology

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 83 58 46 69 62 74 39 61 28 135 655

Second Employer 20 19 13 19 14 14 10 17 7 16 149

Third Employer 7 3 7 5 2 2 1 3 0 1 31

Fourth Employer 1 0 0 0 0 0 0 0 1 0 2



psychologists workingsessions in

clinical health psychology 275 198 163 230 193 223 124 200 89 376 2071

Estimated % of total sessions/week in

clinical health psychology: UK 13% 10% 8% 11% 9% 11% 6% 10% 4% 18% 100%

Estimated no.UK psychologists/100,000

population working sessions in clinical

health psychology 3.23


psychologists working in clinical health

psychology 18.32%



Table 63 No. of UK clinical psychologists working in clinical health services

Sessions worked in child and family services constitute around 8.4% of total sessions (w.t.e.) of UK clinical psychology services.

Figure 104 Estimated no. of UK clinical psychologists working in clinical health services

Figure 105 Estimated percentage of UK clinical psychologists working in clinical health services by sessions/week

Sessions/week of clinical psychology in clinical health psychology

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 83 116 138 276 310 444 273 488 252 1350 3730

Second Employer 20 38 39 76 70 84 70 136 63 160 756

Third Employer 7 6 21 20 10 12 7 24 0 10 117

Fourth Employer 1 0 0 0 0 0 0 0 9 0 10


UK Estimated sessions in clinical health

psychology/week 275 396 490 921 965 1336 866 1604 802 3762 11416



psychology 23 33 41 77 81 112 72 134 67 314 954



psychology 8.44%

Estimated w.t.e. UK


working in clinical health psychology 1.49

275

198

163

230

193223

124

200

89

376

0

50

100

150

200

250

300

350

400

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in clinical health psychology

13%

10%8%

11%9%

11%

6%

10%

4%

18%

0%

5%

10%

15%

20%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in clinical health services by sessions/week



There is a fairly even spread in terms of number of sessions/week worked in clinical health services and 18% of respondents are full time.

Figure 106 Estimated total UK clinical psychology sessions/week in clinical health services

Figure 107 Estimated headcount and w.t.e. of UK clinical psychologists working in clinical health psychology

10.13 Commissioning

Table 64 No of UK clinical psychologists working in commissioning

A very small percentage (0.9%) of UK clinical psychologists work sessions in commissioning.

275396 490

921 965

1336

866

1604

802

3762

0

500

1000

1500

2000

2500

3000

3500

4000

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

UK Estimated sessions in clinical health psychology/week

275

198

163

230

193

223

124

200

89

376

23 33 41

77 81

112

72

134

67

314

0

50

100

150

200

250

300

350

400

1 2 3 4 5 6 7 8 9 10

Estimated headcount and w.t.e of UK clinical psychologists working in clinical health services

Estimated no. of UK clinical psychologists workingsessions in clinical health psychology

Estimated w.t.e of UK clinical psychologists working in clinical health psychology

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 20 6 0 2 1 0 0 0 0 1 30

Second Employer 7 1 0 1 1 0 0 0 0 0 10

Third Employer 0 0 0 0 0 0 0 0 0 1 1

Fourth Employer 0 0 0 0 0 0 0 0 0 0 0


Estimated no. of UK clinical psychologists

working in commissioning 67 17 0 7 5 0 0 0 0 5 101


commissioning: UK 66% 17% 0% 7% 5% 0% 0% 0% 0% 5% 100%


population working in commissioning 0.16

Estimated % of total UK clinical psychologists

working in commissioning 0.90%

No. of clinical psychologists working in commissioning



Table 65 No. of sessions/week of UK clinical psychologists working in commissioning

Only 0.14% of total UK clinical psychology sessions are in commissioning services.

Figure 108 Estimated no. of UK clinical psychologists working in commissioning

Figure 109 Estimated percentage of UK clinical psychologists working in commissioning by sessions/week

The vast majority (66%) of clinical psychologists working in commissioning have only one or two sessions per week for this work.

Sessions/week of clinical psychology in commissioning

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 20 12 0 8 5 0 0 0 0 10 55

Second Employer 7 2 0 4 5 0 0 0 0 0 18

Third Employer 1 0 0 0 0 0 0 0 0 0 1

Fourth Employer 0 0 0 0 0 0 0 0 0 0 0


UK Estimated sessions in commissioning/week 69 35 0 30 25 0 0 0 0 25 183

Estimated w.t.e of UK clinical psychologists

working in commissioning 6 3 0 2 2 0 0 0 0 2 15

Estimated % w.t.e of UK clinical psychologists

working in commissioning 0.14%

Estimated w.t.e. UK psychologists/100,000

population working in commissioning 0.02

67

17

0

75

0 0 0 05

0

10

20

30

40

50

60

70

80

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in commissioning

66%

17%

0%

7%5%

0% 0% 0% 0%5%

0%

10%

20%

30%

40%

50%

60%

70%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in commissioning by sessions/week



Figure 110 Estimated total sessions/week working in commissioning: UK clinical psychologists

Figure 111 Estimated headcount and w.t.e of UK clinical psychologists working in commissioning

10.14 Consultancy

Table 66 No. of clinical psychologists working sessions in consultancy

Around 9.6% of UK clinical psychologists undertake some sessional work in consultancy.

28

14

0

12

10

0 0 0 0

10

0

5

10

15

20

25

30

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

Estimated total sessions/week working in commissioning: UK clinical psychologists

67

17

07 5

0 0 0 056 3 0 2 2 0 0 0 0 2

0

10

20

30

40

50

60

70

80

1 2 3 4 5 6 7 8 9 10

Estimated headcount and w.t.e UK clinical psychologists working in commissioning

Estimated no. of UK clinical psychologists working in commissioning

Estimated w.t.e of UK clinical psychologists working in commissioning

No. of clinical psychologists working in consultancy

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 145 87 25 23 15 14 6 8 4 10 337

Second Employer 40 20 7 5 1 4 1 1 1 2 82

Third Employer 8 5 3 0 0 1 0 1 0 0 18

Fourth Employer 0 0 1 0 0 0 0 0 0 0 1


Estimated no. of UK clinical psychologists working sessions in

consultancy 478 277 89 69 40 47 17 25 12 30 1084

Estimated % of total sessions/week in consultancy: UK 44% 26% 8% 6% 4% 4% 2% 2% 1% 3% 100%

Estimated no.UK psychologists/100,000 population working

sessions in consultancy 1.69

Estimated % of total UK clinical psychologists working sessions

in consultancy 9.59%



Table 67 Total no. of sessions/week of clinical psychologists working in consultancy

Sessions worked in consultancy account for only around 2% of UK clinical psychology time available.

Figure 112 Estimated no. of UK clinical psychologists working in consultancy

Figure 113 Estimated percentage of UK clinical psychologists working in consultancy by sessions/week

The vast majority of UK clinical psychologists undertaking consultancy work have only 1-2 sessions per week for this activity.

Sessions/week of clinical psychology in consultancy

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 145 174 75 92 75 84 42 64 36 100 887

Second Employer 40 40 21 20 5 24 7 8 9 20 194

Third Employer 8 10 9 0 0 6 0 8 0 0 41

Fourth Employer 0 0 3 0 0 0 0 0 0 0 3


UK Estimated sessions in consultancy/week 478 554 267 277 198 282 121 198 111 297 2784

Estimated w.t.e of UK clinical psychologists working in

consultancy 40 46 22 23 17 24 10 17 9 25 233

Estimated % w.t.e of UK clinical psychologists working in

consultancy 2.06%

Estimated w.t.e. UK psychologists/100,000 population working

in consultancy 0.36

478

277

89 6940 47

17 25 12 30

0

100

200

300

400

500

600

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in consultancy

44%

26%

8%6%

4% 4%2% 2% 1%

3%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in consultancy by sessions/week



Figure 114 Estimated total sessions/week in consultancy: UK clinical psychologists

Figure 115 Estimated headcount and w.t.e. of UK clinical psychologists working in consultancy

10.15 Eating Disorders

Table 68 No. of UK clinical psychologists working in eating disorders

Around 4.3% of UK clinical psychologists work sessions in eating disorders.

Table 69 No. of sessions/week of UK clinical psychologists working in eating disorders

193

224

108 112

80

114

49

80

45

120

0

50

100

150

200

250

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

UK Estimated sessions in consultancy/week

478

277

8969

40 4717 25 12 3040 46

22 23 17 24 10 17 9 25

0

100

200

300

400

500

600

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e of UK clinical psychologists working in consultancy

Estimated no. of UK clinical psychologists working sessions in consultancy

Estimated w.t.e of UK clinical psychologists working in consultancy

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 43 22 16 10 6 14 5 10 2 26 154

Second Employer 5 3 3 3 1 7 2 1 0 5 30

Third Employer 2 3 1 2 0 1 1 0 0 0 10

Fourth Employer 0 1 0 0 0 0 0 0 0 0 1



psychologists working in eating disorder 124 72 49 37 17 54 20 27 5 77 483


eating disorder : UK 26% 15% 10% 8% 4% 11% 4% 6% 1% 16% 100%


population working in eating disorder 0.75


psychologists working in eating disorder 4.27%

No. of clinical psychologists working in eating disorder



The number of UK clinical psychology sessions worked in eating disorders accounts for around 1.6% of total w.t.e sessions available.

Figure 116 Estimated no. of UK clinical psychologists working in eating disorders

Figure 117 Estimated percentage of UK clinical psychologists in eating disorder by sessions/week

Sessions/week of clinical psychology in eating disorders

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 43 44 48 40 30 84 35 80 18 260 682

Second Employer 5 6 9 12 5 42 14 8 0 50 151

Third Employer 2 6 3 8 0 6 7 0 0 0 32

Fourth Employer 0 2 0 0 0 0 0 0 0 0 2


UK Estimated sessions in eating

disorders/week 124 144 148 148 87 327 139 218 45 767 2146


psychologists working in eating

disorders 10 12 12 12 7 27 12 18 4 64 179


psychologists working in eating

disorders 1.59%

Estimated w.t.e. UK


working in eating disorders 0.28

124

72

49 37

17

54

20 27

5

77

0

20

40

60

80

100

120

140

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in eating disorder

26%

15%

10%8%

4%

11%

4%6%

1%

16%

0%

5%

10%

15%

20%

25%

30%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in eating disorders by sessions/week



The majority of psychologists working in eating disorders work for 1-2 sessions in this specialty with 16% working full time.

Figure 118 Estimated total sessions/week of UK clinical psychologists working in eating disorders

Figure 119 Estimated headcount and w.t.e. of UK clinical psychologists working in eating disorders

124 144 148 14887

327

139218

45

767

0

100

200

300

400

500

600

700

800

900

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

UK Estimated sessions in eating disorder/week

124

72

4937

17

54

2027

5

77

10 12 12 127

27

1218

4

64

0

20

40

60

80

100

120

140

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e of UK psychologists working in eating disorders

Estimated no. of UK clinical psychologists working in eating disorder

Estimated w.t.e of UK clinical psychologists working in eating disorders



10.16 Forensic Services

Table 70 No. of clinical psychologists working in forensic services

Around 10.5% of UK clinical psychologists undertake sessions in forensic services.

Table 71 No. of sessions/week of clinical psychology in forensic services

Sessions worked in forensic services account for around 5.2% of total w.t.e sessions for UK clinical psychologists.

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 41 35 33 35 30 33 21 39 18 93 378

Second Employer 8 7 11 11 10 9 6 10 3 18 93

Third Employer 1 0 1 2 0 2 1 0 1 0 8

Fourth Employer 0 0 0 0 0 0 1 0 1 0 2



psychologists working in forensic

services 124 104 111 119 99 109 72 121 57 275 1190


forensic services : UK 10% 9% 9% 10% 8% 9% 6% 10% 5% 23% 100%


population working in forensic

services 1.86



services 10.53%

No. of clinical psychologists working in forensic services

Sessions/week of clinical psychology in forensic services

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 41 70 99 140 150 198 147 312 162 930 2249

Second Employer 8 14 33 44 50 54 42 80 27 180 532

Third Employer 1 0 3 8 0 12 7 0 9 0 40

Fourth Employer 0 0 0 0 0 0 7 0 9 0 16


UK Estimated sessions in forensic

services/week 124 208 334 475 495 653 502 970 512 2747 7021



services 10 17 28 40 41 55 42 81 43 230 587



services 5.19%

Estimated w.t.e. UK


working in forensic services 0.92



Figure 120 Estimated no. of UK clinical psychologists working in forensic services

Figure 121 Estimated percentage of UK clinical psychologists working in forensic services by sessions/week

The majority of psychologists working in forensic services are full time (23%).

Figure 122 Estimated total no. of clinical psychology sessions/week in forensic services

124104 111 119

99109

72

121

57

275

0

50

100

150

200

250

300

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in forensic services

10%9% 9% 10%

8%9%

6%

10%

5%

23%

0%

5%

10%

15%

20%

25%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in forensic services by sessions/week

124 208334

475 495653

502

970

512

2747

0

500

1000

1500

2000

2500

3000

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

UK Estimated sessions in forensic services/week



10.17 HIV Sexual Health

Table 72 No. of clinical psychologists working in HIV/sexual health

Around 1.7% of UK clinical psychologists work sessions in HIV/sexual health.

124

104111

119

99109

72

121

57

275

1017

2840 41

5542

81

43

230

0

50

100

150

200

250

300

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e of UK clinical psychologists in forensic services

Estimated no. of UK clinical psychologists working in forensic services

Estimated w.t.e of UK clinical psychologists working in forensic services

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 10 10 5 4 13 5 2 4 1 4 58

Second Employer 2 5 1 1 5 3 0 1 0 0 18

Third Employer 0 2 0 0 0 0 0 0 0 0 2

Fourth Employer 0 0 0 0 0 0 0 0 0 0 0



psychologists working in

HIV/Sexual health 30 42 15 12 45 20 5 12 2 10 193

Estimated % of total

sessions/week in HIV/Sexual

healthservices : UK 15% 22% 8% 6% 23% 10% 3% 6% 1% 5% 100%

Estimated no.UK


working in HIV/Sexual health 0.30



HIV/Sexual health 1.71%

No. of clinical psychologists working in HIV/Sexual health



Table 73 No of clinical psychology sessions/week in HIV/sexual health services

Sessions in HIV/Sexual health account for around 0.6% of total UK clinical psychology sessions.

Figure 123 Estimated no. of UK clinical psychologists working in HIV/sexual health

Sessions/week of clinical psychology in HIV/sexual health

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 10 20 15 16 65 30 14 32 9 40 251

Second Employer 2 10 3 4 25 18 0 8 0 0 70

Third Employer 0 4 0 0 0 0 0 0 0 0 4

Fourth Employer 0 0 0 0 0 0 0 0 0 0 0


UK Estimated sessions in

HIV/sexual healths/week 30 84 45 49 223 119 35 99 22 99 804



HIV/sexual health 2 7 4 4 19 10 3 8 2 8 67



HIV/sexual health 0.59%

Estimated w.t.e. UK


working in HIV/sexual health 0.10

30

42

15

12

45

20

5

12

2

10

0

5

10

15

20

25

30

35

40

45

50

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in HIV/Sexual health



Figure 124 Estimated % of UK clinical psychologists working in HIV/sexual health services by sessions/week

The majority of psychologists working in HIV/sexual health are part-time (less than 6 sessions per week).

Figure 125 Estimated total UK clinical psychology sessions/week in HIV/sexual health

15%

22%

8%6%

23%

10%

3%

6%

1%

5%

0%

5%

10%

15%

20%

25%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in HIV/sexual health services by sessions/week

30

84

45 49

223

119

35

99

22

99

0

50

100

150

200

250

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

UK Estimated sessions in HIV/Sexual health/week



Figure 126 Estimated headcount and w.t.e. of UK clinical psychologists working in HIV/sexual health services

10.18 Learning Disability

Table 74 No. of UK clinical psychologists working in learning disability services

Around 21% of UK clinical psychologists work sessions in learning disability.

30

42

1512

45

20

5

12

2

10

2

7

4 4

19

10

3

8

2

8

0

5

10

15

20

25

30

35

40

45

50

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e of UK clinical psychologists working in HIV/Sexual health services

Estimated no. of UK clinical psychologists working in HIV/Sexual health

Estimated w.t.e of UK clinical psychologists working in HIV/sexual health

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 102 76 61 85 72 106 56 92 37 136 823

Second Employer 13 10 7 14 12 20 11 16 6 15 124

Third Employer 3 0 0 1 1 4 0 0 1 0 10

Fourth Employer 0 0 0 0 1 0 0 0 1 0 2



working sessions in learning disability 292 213 168 247 213 322 166 267 111 374 2373


learning disability : UK 12% 9% 7% 10% 9% 14% 7% 11% 5% 16% 100%


population working sessions in learning

disability 3.70


psychologists working in learning

disability 20.99%

No. of clinical psychologists working in learning disability



Table 75 No. of UK clinical psychology sessions working in learning disability services

Sessions worked in learning disability account for 9.8% of total sessions available for UK clinical psychology services.

Figure 127 Estimated no. of UK clinical psychologists working in learning disability

Figure 128 Estimated % of UK clinical psychologists working in learning disability by sessions/week

There is a fairly even spread of sessions/week for UK clinical psychologists working in learning disability with 16% full time.

Sessions/week of clinical psychology in learning disability

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 102 152 183 340 360 636 392 736 333 1360 4594

Second Employer 13 20 21 56 60 120 77 128 54 150 699

Third Employer 3 0 0 4 5 24 0 0 9 0 45

Fourth Employer 0 0 0 0 5 0 0 0 9 0 14


UK Estimated sessions in learning

disability/week 292 426 505 990 1064 1930 1161 2138 1002 3737 13245



disability 24 36 42 83 89 161 97 179 84 312 1107



disability 9.79%

Estimated w.t.e. UK

psychologists/100,000 population working

in learning disability 1.73

292

213

168

247

213

322

166

267

111

374

0

50

100

150

200

250

300

350

400

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working in learning disability

12%

9%

7%

10%

9%

14%

7%

11%

5%

16%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in learning disability by sessions/week



Figure 129 Estimated headcount and w.t.e of UK clinical psychologists working in learning disability

10.19 Management

Table 76 No. of UK clinical psychologists working in management

Approximately 12.3% of UK clinical psychologists undertake some work in management.

292

213

168

247

213

322

166

267

111

374

2436 42

83 89

161

97

179

84

312

0

50

100

150

200

250

300

350

400

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e of UK clinical psychologists working in learning disability

Estimated no. of UK clinical psychologists working sessions in learning disability

Estimated w.t.e of UK clinical psychologists working in learning disability

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 106 103 51 59 40 32 15 26 12 15 459

Second Employer 26 24 7 8 10 5 1 3 1 4 89

Third Employer 6 2 0 2 2 1 0 0 0 1 14

Fourth Employer 0 0 0 0 1 0 0 0 0 1 2




management 342 319 144 171 131 94 40 72 32 52 1396


management : UK 24% 23% 10% 12% 9% 7% 3% 5% 2% 4% 100%


population working sessions in

management 2.18


psychologists working in management 12.35%

No. of clinical psychologists working in management



Table 77 No. of clinical psychology sessions in management

Sessions worked in management account for around 3.7% of available clinical psychology sessions.

Figure 130 Estimated no. of clinical psychologists working in management

Figure 131 Estimated % of UK clinical psychologists working in management by sessions/week

The majority of clinical psychologists working in management have only 1-2 sessions/week for this work.

Sessions/week of clinical psychology in management

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 106 206 153 236 200 192 105 208 108 150 1664

Second Employer 26 48 21 32 50 30 7 24 9 40 287

Third Employer 6 4 0 8 10 6 0 0 0 10 44

Fourth Employer 0 0 0 0 5 0 0 0 0 10 15



management/week 342 639 431 683 656 564 277 574 290 520 4974


psychologists working in management 29 53 36 57 55 47 23 48 24 43 416


psychologists working in management 3.68%

Estimated w.t.e. UK


working in management 0.65

342319

144171

131

94

4072

3252

0

50

100

150

200

250

300

350

400

1 2 3 4 5 6 7 8 9 10

Sessions per week

Estimated no. of UK clinical psychologists working in management

24%23%

10%12%

9%7%

3%5%

2%4%

0%

5%

10%

15%

20%

25%

30%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in management by sessions/week



Figure 132 Estimated sessions/week in management

Figure 133 Estimated no. and w.t.e. of UK clinical psychologists working in management

10.20 Neuropsychology

The following data is from the Online Survey of Clinical Psychologists in the UK which asked respondents for information about the sessions worked in various specialties. From responses, the number of clinical psychologists reporting 1-10 sessions per week work in neuropsychology is estimated and the number of respondents on the Neuropsychology Register is also reported.

There were 4568 respondents to the survey and the total number of UK clinical psychologists on the HCPC UK register is 11,900. Thus, the total number of clinical psychologists undertaking sessional work in neuropsychology and the total number on the Neuropsychology Register can be estimated. However, some caution is needed in this extrapolation, although survey respondents are representative of HCPC registered clinical psychologists in terms of their social demographic characteristics.

342

639

431

683656

564

277

574

290

520

0

100

200

300

400

500

600

700

800

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions pwer week

UK Estimated sessions/week in management

342

319

144

171

131

94

40

72

32

52

29

5336

57 5547

23

48

24

43

0

50

100

150

200

250

300

350

400

1 2 3 4 5 6 7 8 9 10

Estimated no. and w.t.e of UK clinical psychologists working in management

Estimated no. of UK clinical psychologists working sessions in management

Estimated w.t.e of UK clinical psychologists working in management



Figure 134 No. of clinical psychologists working in neuropsychology, sessions and no. on specialist register of neuropsychologists (online survey n=4568).

A minority (25%) of clinical psychologists working in neuropsychology are on the specialist neuropsychology register.

Table 78 No. of UK clinical psychologists working in neuropsychology

Around 20.5% of UK clinical psychologists undertake some sessional work in neuropsychology.

Table 79 No. of sessions/week in neuropsychology

0

20

40

60

80

100

120

140

160

1 2 3 4 5 6 7 8 9 10

no. of sessions

Clinical Psychologists working in neuropsychology (UK)

Neuropsychology sessions/week

no. working in neuropsychology

no. on neuropsychology register

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 133 83 61 66 49 72 36 57 24 124 705

Second Employer 31 17 14 22 17 26 9 18 8 36 198

Third Employer 3 2 2 4 2 5 2 2 2 5 29

Fourth Employer 1 0 0 0 0 0 0 0 1 1 3



psychologists working sessions

in neuropsychology 416 252 191 228 168 255 116 191 87 411 2314


sessions/week in

neuropsychology : UK 17.97% 10.91% 8.24% 9.84% 7.27% 11.02% 5.03% 8.24% 3.74% 17.75% 100.00%

Estimated no.UK


working sessions in

neuropsychology 3.61



neuropsychology 20.47%

No. of clinical psychologists working in neuropsychology



Sessions worked in neuropsychology account for around 10.6% of UK clinical psychology sessions.

Around 237 survey respondents were on the specialist neuropsychology register. It is estimated that the UK expected number on the register (pro-rated) would be around 511 individuals.

Figure 135 Estimated no. of UK clinical psychologists working sessions in neuropsychology

Figure 136 Estimated % of UK clinical psychologists working in neuropsychology by sessions/week

Sessions/week of clinical psychology in neuropsychology

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 133 166 183 264 245 432 252 456 216 1240 3587

Second Employer 31 34 42 88 85 156 63 144 72 360 1075

Third Employer 3 4 6 16 10 30 14 16 18 50 167

Fourth Employer 1 0 0 0 0 0 0 0 9 10 20



neuropsychology/week 363 440 498 794 734 1334 710 1329 680 3582 10463



neuropsychology 36 44 50 79 73 133 71 133 68 358 1046



neuropsychology 10.62%

Estimated w.t.e. UK


working in neuropsychology 1.63

Number on neuropsychology

register (online survey) 237

Estimated number on

neuropsychology register (online

survey) 511

416

252

191228

168

255

116

191

87

411

0

50

100

150

200

250

300

350

400

450

1 2 3 4 5 6 7 8 9 10

Estimated no. of UK clinical psychologists working sessions in neuropsychology



29% of UK clinical psychologists work 1-2 sessions in neuropsychology and 22% work 9-10 sessions.

Figure 137 Estimated sessions per week in neuropsychology

Figure 138 Estimated headcount and w.t.e. of UK clinical psychologists working in neuropsychology

10.21 Older Adults

Table 80 No. of UK clinical psychologists working in older adult services

18%

11%

8%10%

7%

11%

5%

8%

4%

18%

0%

5%

10%

15%

20%

1 2 3 4 5 6 7 8 9 10

Estimated % of UK clinical psychologists working in neuropsychology by sessions/week

0

50

100

150

200

250

300

350

400

450

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e. of UK clinical psychologists working in neuropsychology

Estimated no. of UK clinical psychologists working sessions in neuropsychology

Estimated no. of UK clinical psychologists working sessions in learning disability



Around 12.3% of UK clinical psychologists undertake some sessional work in older adult services.

Table 81 No of UK clinical psychology sessions/week in older adult services

Sessions worked in older adult services constitute around 5.6% of available UK clinical psychology sessions.

Figure 139 Estimated no. of UK clinical psychologists working in older adult services

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 64 47 43 53 45 61 30 44 22 84 493

Second Employer 8 8 8 9 4 9 3 5 3 9 66

Third Employer 0 0 2 1 0 0 0 0 1 1 5

Fourth Employer 0 0 0 0 0 0 0 0 1 0 1



working sessions in older adults 178 136 131 156 121 173 82 121 67 233 1398


older adults : UK 13% 10% 9% 11% 9% 12% 6% 9% 5% 17% 100%


population working sessions in older

adults 2.181398


psychologists working sessions in older

adults 12.37%

No. of clinical psychologists working in older adults

Sessions/week of clinical psychology in older adults

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 64 94 129 212 225 366 210 352 198 840 2690

Second Employer 8 16 24 36 20 54 21 40 27 90 336

Third Employer 0 0 6 4 0 0 0 0 9 10 29

Fourth Employer 0 0 0 0 0 0 0 0 9 0 9


UK Estimated sessions in older

adults/week 178 272 393 624 606 1039 572 970 601 2326 7583


psychologists working in older adults 15 23 33 52 51 87 48 81 50 194 634


psychologists working in older adults 5.60%

Estimated w.t.e. UK


working in older adults 0.99

178

136 131

156

121

173

82

121

67

233

0

50

100

150

200

250

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no of UK clinical psychologists working in older adult services



Figure 140 Estimated % of UK clinical psychologists working in older adult services by sessions/week

Around 17% of UK clinical psychologists working in older adult services are full time.

Figure 141 Estimated total UK clinical psychology sessions in older adult services

13%

10% 9%

11%

9%

12%

6%

9%

5%

17%

0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated %of UK clinical psychologists working in older adult services by sessions/week

178272

393

624 606

1039

572

970

601

2326

0

500

1000

1500

2000

2500

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

Estimated sessions/week in older adult services: UK clinical psychology



Figure 142 Estimated headcount and w.t.e. UK clinical psychologists working in older adult services

10.22 Paediatric psychology

Table 82 No. of UK clinical psychologists working in paediatric services

Around 10.9% of UK clinical psychologists work sessions in paediatric services.

178

136 131

156

121

173

82

121

67

233

1523

33

52 51

87

48

81

50

194

0

50

100

150

200

250

1 2 3 4 5 6 7 8 9 10

Estimated headcount and w.t.e. UK clinical psychologists working in older adult services

Estimated no. of UK clinical psychologists working sessions in older adults

Estimated w.t.e of UK clinical psychologists working in older adults

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 49 46 25 53 54 58 29 25 16 55 410

Second Employer 9 12 4 17 18 12 5 4 2 4 87

Third Employer 0 1 0 1 0 0 0 0 0 0 2

Fourth Employer 0 0 0 0 0 0 0 0 0 0 0

Totals (from online

survey) 58 59 29 71 72 70 34 29 18 59 499

Estimated no. of UK

clinical psychologists

working sessions in

paediatrics 125 127 63 153 155 151 73 63 39 127 1077


sessions/week in

paediatrics : UK 12% 12% 6% 14% 14% 14% 7% 6% 4% 12% 100%

Estimated no.UK

psychologists/100,000

population working

sessions in paediatrics 1.68

Estimated % of total UK


working sessions in

paediatrics 10.92%

No. of clinical psychologists working in paediatrics



Table 83 No. of UK clinical psychologist sessions/week in paediatric services

Sessions worked in paediatric services amount to 4.7% of total UK clinical psychology sessions available.

Figure 143 No. of UK clinical psychologists working in paediatric services

Sessions/week of clinical psychology in paediatrics

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 49 92 75 212 270 348 203 200 144 550 2143

Second Employer 9 24 12 68 90 72 35 32 18 40 400

Third Employer 0 2 0 4 0 0 0 0 0 0 6

Fourth Employer 0 0 0 0 0 0 0 0 0 0 0

Totals (from online

survey) 58 118 87 284 360 420 238 232 162 590 2549

UK Estimated sessions

in paediatrics/week 144 292 215 703 891 1039 589 574 401 1460 6308

Estimated w.t.e of UK


working in paediatrics 12 24 18 59 74 87 49 48 33 122 527

Estimated % w.t.e of

UK clinical psychologists

working in paediatrics 4.66%

Estimated w.t.e. UK


population working in

paediatrics 0.82

144 146

72

176 178 173

8472

45

146

0

20

40

60

80

100

120

140

160

180

200

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working sessions in paediatrics



Figure 144 Estimated % of UK clinical psychologists working in paediatric services by sessions/week

The majority of UK clinical psychologists working in paediatrics are part-time (4-6 sessions per week).

Figure 145 Estimated UK clinical psychology sessions/week in paediatric services

12% 12%

6%

14% 14% 14%

7%6%

4%

12%

0%

2%

4%

6%

8%

10%

12%

14%

16%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in paediatric services by sessions/week

144

292215

703

891

1039

589 574

401

1460

0

200

400

600

800

1000

1200

1400

1600

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

UK Estimated sessions per week in paediatrics: UK clinical psychology



Figure 146 Estimated headcount and w.t.e. of UK clinical psychologists working in paediatric services

10.23 Perinatal psychology

Table 84 No. of clinical psychologists working in perinatal services

Around 2.4% of UK clinical psychologists work sessions in perinatal services.

144 146

72

176 178173

84

72

45

146

12

2418

59

74

87

49 48

33

122

0

20

40

60

80

100

120

140

160

180

200

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e UK clinical psychologists in paediatrics

Estimated no. of UK clinical psychologists working sessions in consultancy

Estimated w.t.e of UK clinical psychologists working in paediatrics

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 19 9 5 6 12 8 6 3 2 5 75

Second Employer 4 7 2 4 4 3 2 1 1 2 30

Third Employer 0 1 0 1 1 0 1 0 0 0 4

Fourth Employer 0 0 0 0 0 0 0 0 0 0 0


Estimated no. of UK


working sessions in

perinatal services 57 42 17 27 42 27 22 10 7 17 270


sessions/week in

perinatal services : UK 21% 16% 6% 10% 16% 10% 8% 4% 3% 6% 100%

Estimated no.UK


population working

sessions in perinatal

services 0.42



working sessions in

perinatal services 2.39%

No. of clinical psychologists working in perinatal services



Table 85 No. of UK clinical psychology sessions in perinatal services

Sessions in perinatal services account for about 0.9% of total UK clinical psychology sessions available.

Figure 147 Estimated no. of UK clinical psychologists working in perinatal services

Figure 148 Estimated % of UK clinical psychologists working in perinatal services by sessions/week

Sessions/week of clinical psychology in perinatal services

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 19 18 15 24 60 48 42 24 18 50 318

Second Employer 4 14 6 16 20 18 14 8 9 20 129

Third Employer 0 2 0 4 5 0 7 0 0 0 18

Fourth Employer 0 0 0 0 0 0 0 0 0 0 0



perinatal services/week 57 84 52 109 210 163 156 79 67 173 1151



working in perinatal

services 5 7 4 9 18 14 13 7 6 14 96

Estimated % w.t.e of UK


working in perinatal

services 0.85%

Estimated w.t.e. UK



perinatal services 0.149995

57

42

17

27

42

2722

10 7

17

0

10

20

30

40

50

60

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working sessions in perinatal services



Most psychologists working in perinatal services are part-time with 37% having only 1-2 sessions per week in this specialty.

21%

16%

6%

10%

16%

10%8%

4%3%

6%

0%

5%

10%

15%

20%

25%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in perinatal services by sessions/week



Figure 149 No. of UK clinical psychology sessions/week in perinatal services

Figure 150 Estimated headcount and w.t.e. of UK clinical psychologists working in perinatal services

10.24 Primary care

Table 86 No. of clinical psychologists working in primary care services

57

84

52

109

210

163156

7967

173

0

50

100

150

200

250

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

UK Estimated sessions in perinatal services/week

5742

1727

4227 22

10 717

270

5 7 4 9 18 14 13 7 614

0

50

100

150

200

250

300

1 2 3 4 5 6 7 8 9 10 11

sessions per week

Estimated headcount and w.t.e of UK clinical psychologists working in perinatal services

Estimated no. of UK clinical psychologists working sessions in perinatal services

Estimated w.t.e of UK clinical psychologists working in perinatal services



Around 3.1% of clinical psychologists work sessions in primary care services.

Table 87 No. of UK clinical psychology sessions/week in primary care services

Sessions worked in primary care account for around 1.1% of total UK clinical psychology sessions worked.

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 23 22 5 8 3 11 4 6 6 11 99

Second Employer 8 5 1 3 1 5 3 3 4 1 34

Third Employer 2 2 0 1 0 0 0 0 0 0 5

Fourth Employer 0 2 0 0 0 0 0 0 0 0 2




in primary care services 82 77 15 30 10 40 17 22 25 30 346


sessions/week in primary care

services : UK 24% 22% 4% 9% 3% 11% 5% 6% 7% 9% 100%

Estimated no.UK


population working sessions in

primary care services 0.54



in primary care services 3.06%

No. of clinical psychologists working in primary care services

Sessions/week of clinical psychology in primary care services

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 23 44 15 32 15 66 28 48 54 110 435

Second Employer 8 10 3 12 5 30 21 24 36 10 159

Third Employer 2 4 0 4 0 0 0 0 0 0 10

Fourth Employer 0 4 0 0 0 0 0 0 0 0 4



primary care services/week 82 153 45 119 49 238 121 178 223 297 1505



primary care services 7 13 4 10 4 20 10 15 19 25 126


clinical psychologists working

in primary care services 1.11%

Estimated w.t.e. UK


population working in primary

care services 0.20



Figure 151 Estimated no. of UK clinical psychologists working in primary care services

Figure 152 Estimated % of UK clinical psychologists working in primary care by sessions/week

The majority of UK clinical psychologists working sessions in primary care are part-time with 46% having only 1-2 sessions per week in this specialty.

8277

15

30

10

40

1722 25

30

0

10

20

30

40

50

60

70

80

90

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working sessions in primary care services

24%

22%

4%

9%

3%

11%

5%

6%7%

9%

0%

5%

10%

15%

20%

25%

1 2 3 4 5 6 7 8 9 10sessions per week

Estimated % of UK clinical psychologists working in primary care by sessions/week



Figure 153 Estimated UK clinical psychology sessions/week in primary care

Figure 154 Estimated headcount and w.t.e. of UK clinical psychologists working in primary care

82

153

45

119

49

238

121

178

223

297

0

50

100

150

200

250

300

350

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

UK Estimated sessions in primary care services/week

8277

15

30

10

40

1722

2530

7

13

4

10

4

20

1015

19

25

0

10

20

30

40

50

60

70

80

90

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e of UK clinical psychologists working in primary care

Estimated no. of UK clinical psychologists working sessions in primary care services

Estimated w.t.e of UK clinical psychologists working in primary care services



10.25 Teaching/training others

Table 88 No. of clinical psychologists working in teaching/training others

Around 10.3% of clinical psychologists are involved in teaching and training other professionals.

Table 89 No. of UK clinical psychology sessions/week in teaching/training others

Sessions in teaching and training other professionals account for around 2.2% of total sessions available.

Figure 155 Estimated no. of UK clinical psychologists working in teaching/training others

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 176 59 24 42 27 20 9 15 10 11 393

Second Employer 19 6 5 4 5 4 5 0 2 2 52

Third Employer 11 6 0 2 2 2 0 0 0 0 23

Fourth Employer 0 3 0 0 0 0 0 0 0 0 3




teaching/training others 510 183 72 119 84 64 35 37 30 32 1166


sessions/week in

teaching/training others : UK 44% 16% 6% 10% 7% 6% 3% 3% 3% 3% 100%

Estimated no.UK


working sessions in

teaching/training others 1.818475



teaching/training others 10.31%

No. of clinical psychologists working in teaching/training others

Sessions/week of clinical psychology in teaching/training others

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 248 138 69 68 35 72 49 48 18 90 835

Second Employer 66 38 18 20 20 30 28 40 0 20 280

Third Employer 11 12 0 8 10 12 0 0 0 0 53

Fourth Employer 0 6 0 0 0 0 0 0 0 0 6



teaching/training others/week 804 480 215 238 161 282 191 218 45 272 2905






teaching/training others 2.15%

Estimated w.t.e. UK


working in teaching/training

others 0.38



Figure 156 Estimated % of UK clinical psychologists working in teaching/training others by sessions/week

The majority (60%) of clinical psychologists involved in teaching and training others have only 1-2 sessions for this work.

Figure 157 Estimated UK clinical psychology sessions/week in teaching/training others

510

183

72

11984

6435 37 30 32

0

100

200

300

400

500

600

1 2 3 4 5 6 7 8 9 10

sessions per wee

Estimated no. of UK clinical psychologists working sessions in teaching/training others

44%

16%

6%

10%

7%6%

3% 3% 3% 3%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in teaching/training others by sessions/week



Figure 158 Estimated headcount and w.t.e UK clinical psychologists involved in teaching/training others

804

480

215238

161

282

191218

45

272

0

100

200

300

400

500

600

700

800

900

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

Estimated UK clinical psychology sessions/week in teaching/training others

510

183

72

11984

6435 37 30 32

6740

18 20 13 24 16 18 423

0

100

200

300

400

500

600

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e. UK clinical psychologists involved in teaching/training others

Estimated no. of UK clinical psychologists working sessions in teaching/training others

Estimated w.t.e of UK clinical psychologists working in teaching/training others



10.26 Teaching/training clinical psychologists

Table 90 No. of UK clinical psychologists working in teaching/training clinical psychologists

Around 12.1% of UK clinical psychologists undertake sessions in teaching and training psychologists.

Table 91 No. of UK clinical psychology sessions/week in teaching/training psychologists

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 176 59 24 42 27 20 9 15 10 11 393

Second Employer 46 16 5 25 15 16 3 7 2 2 137

Third Employer 12 2 1 2 1 1 0 1 0 0 20

Fourth Employer 1 1 0 1 0 0 0 0 0 0 3

Totals (from online

survey) 235 78 30 70 43 37 12 23 12 13 553

Estimated no. of UK


working sessions in

teaching psychologists 582 193 74 173 106 92 30 57 30 32 1369


sessions/week in

teaching psychologists

: UK 42% 14% 5% 13% 8% 7% 2% 4% 2% 2% 100%

Estimated no.UK


population working

sessions in teaching

psychologists 2.14


UK clinical

psychologists working

sessions in teaching

psychologists 12.11%

No. of clinical psychologists working in teaching psychologists



Sessions teaching psychologists account for around 3.1% of total UK clinical psychologists’ sessions.

Figure 159 Estimated no. of UK clinical psychologists working in teaching/training psychologists

Sessions/week of clinical psychology in teaching psychologists

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 176 118 72 168 135 120 63 120 90 110 1172

Second Employer 46 32 15 100 75 96 21 56 18 20 479

Third Employer 12 4 3 8 5 6 0 8 0 0 46

Fourth Employer 1 2 0 4 0 0 0 0 0 0 7

Totals (from online

survey) 235 156 90 280 215 222 84 184 108 130 1704

UK Estimated sessions

in teaching

psychologists/week 582 386 223 693 532 549 208 455 267 322 4217



working in teaching

psychologists 49 32 19 58 44 46 17 38 22 27 352

Estimated % w.t.e of

UK clinical


in teaching

psychologists 3.12%

Estimated w.t.e. UK



teaching psychologists 0.55

582

193

74

173

106 92

3057

30 32

0

100

200

300

400

500

600

700

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working sessions in teaching psychologists



Figure 160 Estimated % of UK clinical psychologists working in teaching/training clinical psychologists by sessions/week

The majority (56%) of clinical psychologists involved in teaching/training psychologists have only 1-2 sessions for this work.

Figure 161 Estimated no. sessions teaching psychologists/week

42%

14%

5%

13%

8% 7%

2%4%

2% 2%

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in teaching/training psychologists by sessions/week

582

386

223

693

532549

208

455

267

322

0

100

200

300

400

500

600

700

800

1 2 3 4 5 6 7 8 9 10

sess

ion

s

sessions per week

UK Estimated sessions in teaching psychologists/week



Figure 162 Estimated headcount and w.t.e. UK clinical psychologists involved in teaching/training clinical psychologists

10.27 University/higher education

Table 92 No. of clinical psychologists working in university/higher education

Around 10.1% of UK clinical psychologists work sessions in university/higher education.

582

193

74

173

106 92

3057

30 3249 32 1958 44 46

1738 22 27

0

100

200

300

400

500

600

700

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e UK clinical psychologists involved in teaching psychologists

Estimated no. of UK clinical psychologists working sessions in teaching psychologists

Estimated w.t.e of UK clinical psychologists working in teaching psychologists

Sessions per week

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 69 51 21 70 19 29 9 20 4 18 310

Second Employer 32 18 12 21 7 19 2 11 2 3 127

Third Employer 8 2 2 2 0 4 0 2 0 0 20

Fourth Employer 3 1 0 0 0 0 0 0 0 0 4




sessions in

university/higher education 277 178 87 230 64 129 27 82 15 52 1141


sessions/week in

university/higher education

: UK 24% 16% 8% 20% 6% 11% 2% 7% 1% 5% 100%

Estimated no.UK


population working sessions

in university/higher

education 1.78



working sessions in

university/higher education 10.09%

No. of clinical psychologists working in university/higher education



Table 93 No. of UK clinical psychology sessions/week in university/higher education

Sessions worked in university/higher education account for 3.3% of total UK clinical psychology sessions available.

Figure 163 Estimated no. of UK clinical psychologists working sessions in university/higher education

Sessions/week of clinical psychology in university/higher education

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 69 102 63 280 95 174 63 160 36 180 1222

Second Employer 32 36 36 84 35 114 14 88 18 30 487

Third Employer 8 4 6 8 0 24 0 16 0 0 66

Fourth Employer 3 2 0 0 0 0 0 0 0 0 5



university/higher

education/week 277 356 260 921 322 772 191 653 134 520 4,405



working in




working in university/higher

education 3.26%

Estimated w.t.e. UK



university/higher education 0.57

277

178

87

230

64

129

27

82

15

52

0

50

100

150

200

250

300

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated no. of UK clinical psychologists working sessions in university/higher education



Figure 164 Estimated % of UK clinical psychologists working in university/higher education by sessions/week

The majority (40%) of clinical psychologists working in university/higher education have only 1-2 sessions per week for this work.

Figure 165 Estimated UK clinical psychology sessions/week in university/higher education

24%

16%

8%

20%

6%

11%

2%

7%

1%

5%

0%

5%

10%

15%

20%

25%

30%

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated % of UK clinical psychologists working in university/higher education by sessions/week

277

356

260

921

322

772

191

653

134

520

0

100

200

300

400

500

600

700

800

900

1,000

1 2 3 4 5 6 7 8 9 10

sess

ion

s

session per week

UK Estimated sessions in university/higher education/week



Figure 166 Estimated headcount and w.t.e of UK clinical psychologists working in university/higher education

10.28 Other activity

Table 94 No. of UK clinical psychologists working in "other activities"

277

178

87

230

64

129

27

82

15

52

2330

22

77

27

65

16

55

11

43

0

50

100

150

200

250

300

1 2 3 4 5 6 7 8 9 10

sessions per week

Estimated headcount and w.t.e. UK clinical psychologists in university/higher education

Estimated no. of UK clinical psychologists working sessions in university/higher education

Estimated w.t.e of UK clinical psychologists working in university/higher education

No. of clinical psychologists working in other work

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 74 53 23 48 26 26 11 20 16 37 334

Second Employer 22 15 4 13 6 10 2 3 3 1 79

Third Employer 2 1 2 2 1 1 0 0 1 0 10

Fourth Employer 0 0 0 0 0 0 0 0 1 0 1




other work 243 171 72 156 82 92 32 57 52 94 1049


other work: UK 23% 16% 7% 15% 8% 9% 3% 5% 5% 9% 100%

Estimated no.UK


working sessions in other work 1.637014



other work 9.28%



Around 9.3. % of UK clinical psychologists felt their work could not be adequately described by the specialty definitions and cited a wide variety of work. A few examples included:

Management (e.g. clinical director)

Autism/Adult Asperger’s Syndrome

Pain management

Deaf services

Medico-legal work

Table 95 No of UK clinical psychology sessions in "other work"

Sessions in “other work” accounted for around 3.3% of UK clinical psychology sessions.

Figure 167 No of UK clinical psychologists working in "other areas"

Sessions/week of clinical psychology for other work

1 2 3 4 5 6 7 8 9 10 Totals

Main Employer 74 106 69 192 130 156 77 160 144 370 1478

Second Employer 22 30 12 52 30 60 14 24 27 10 281

Third Employer 2 2 6 8 5 6 0 0 9 0 38

Fourth Employer 0 0 0 0 0 0 0 0 9 0 9


UK Estimated sessions in other

work/week 243 342 215 624 408 549 225 455 468 940 4470


psychologists working in other work 20 29 18 52 34 46 19 38 39 79 373


psychologists working in a other work 3.30%

Estimated w.t.e. UK


working in other work 0.582561

243

171

72

156

8292

32

57 52

94

0

50

100

150

200

250

300

1 2 3 4 5 6 7 8 9 10

No. of psychologists working in other areas



Figure 168 Estimated % of UK clinical psychologists working in "other areas of work" by sessions/week

The majority (39%) of UK clinical psychologists engaged in other areas of work were working 1-2 sessions in these areas.

Figure 169 Estimated UK clinical psychology sessions working in "other areas of work"

Figure 170 Estimated headcount and w.t.e of UK clinical psychologists working in "other areas of work"

23%

16%

7%

15%

8% 9%

3%5% 5%

9%

0%

5%

10%

15%

20%

25%

1 2 3 4 5 6 7 8 9 10

Estimated % of UK clinical psychologists working in "other areas of work" by sessions/week

243

342

215

624

408

549

225

455 468

940

0

200

400

600

800

1000

1 2 3 4 5 6 7 8 9 10

Estimated total sessions/week working in other areas.



10.29 DCP Membership

Table 96 No. of clinical psychologists’ members of BPS and DCP (online survey)

Around two thirds of online survey respondents were full members or in-training members of the DCP However, 13.5% were not members of the DCP and 20% were not members of the BPS. A number of respondents reported that as they had to register with HCPC they did not see added value in becoming members of the BPS. This indicates that they did not recognise HCPC prime function as a regulatory body rather than a professional body supporting the development of psychology.

243

171

72

156

8292

32

57 52

94

2029

18

52

3446

19

38 39

79

0

50

100

150

200

250

300

1 2 3 4 5 6 7 8 9 10

Estimated headcount and w.t.e. of UK clinical psychologists working in "other areas of work"

Estimated no. of UK clinical psychologists working sessions in other work

Estimated w.t.e of UK clinical psychologists working in other work

T ick which

app lies

Response

Count % of total

2920 2920 64.5

126 126 2.8

98 98 2.2

612 612 13.5

1335 1335 29.5

911 911 20.1

4525 100.0

33

General Member of DCP

skipped question

Answer Op tions

Member of BPS

In-Training member of DCP

answered question

Are you a member o f the British Psycho log ica l Soc ie ty D iv is ion o f Clinica l

Psycho logy

Not a member of DCP

Full member of DCP

Not a member of BPS



10.30 Future Needs and Service Gaps: Clinical Psychology Views (online survey 2015)

Further work is underway to obtain a more systematic thematic analysis of the narrative question on current gaps and future needs for clinical psychology but the word cloud below indicates significant professional concerns but also areas for key development for clinical psychology.

In a number of NHS Trusts there has been a lack of professional consultation and engagement in projecting future demand for clinical psychology posts. In a number of Trusts there has been a considerable loss of posts - mainly at more senior consultant psychologist grades and thus there have been – fewer psychology leads for Trust managers to consult.

10.30.1 Some narrative responses

Some illustrative narrative responses from the survey are summarised below to give a flavour or responses:

Had significant pressure this year in relation to reorganisation of psychology service in Trust. Threat to continuation of individual psychology heads at 8d level and replacement with single head of psychology at 8d level (rather than four specialist heads). This has been a significant challenge in relation to ensuring that senior management understands the importance of the top tier of psychology in relation to research, education and training, senior tertiary clinical specialism and leadership (and recognising the importance of this for clinical psychology leadership as well as professional management).

Been saddened that clinical expertise is no longer valued- focus of career progression involves shift to management of budgets which is not reflective of clinical skills or training. Service user feedback is that they want experienced clinicians as first point of contact with services but in order to progress career the role would involve increasingly writing funding proposals and managing

64.5

2.82.2

13.5

29.5

20.1

Professional membership of survey respondents (%)

Full member of DCP Full member of DCP

In-Training member of DCP In-Training member of DCP

General Member of DCP General Member of DCP

Not a member of DCP Not a member of DCP

Member of BPS Member of BPS

Not a member of BPS Not a member of BPS



budgets. I opted to drop a pay scale to retain contact with clients which is what I trained to do!

Although our department is continuing to expand despite the current climate, I am very concerned about the huge difficulty in getting posts upgraded. Staff are taking on more responsibility at lower bandings as a result and it is very difficult to avoid this as people naturally want to develop their skills.

Increasingly I feel it is becoming difficult to offer the quality of therapy/ intervention I would like due to time pressures and competing demands within the NHS. I work with a team who are all stretched and working quickly with less time for reflection as this is less valued by our employers- from the band 4 staff through to consultant on site.

I am using my skills as a psychologist via new ways of working e.g. case management, liaison, supervision, service development more and more than completing direct clinical work

I need more clinical psychology posts in IAPT to deal with the complexity of clients coming through (exclusion criteria in secondary care mean more complex people coming to IAPT).

There should be a n NHS leadership scale to ensure parity of remuneration between different professions in non profession specific leadership roles (e.g. clinical director)

I left the NHS due to limited flexibility in terms of hours at my grade (8a) and little prospect of career progression with part time hours. Career progression for NHS clinical psychologists seems poor compared with when I qualified (2002) and Agenda for Change was unhelpful in this respect in my opinion.

I also believe that there should be free training available to keep up one's practice and or acquire new skills. The Trust themselves do not have the funding for anything other than mandatory training for psychologists

Although there is recognition for posts e.g. for inpatient wards, there does not appear to be the drivers to then put these posts in place. Also there is a continual anxiety about posts being down banded and how we are "value added".

I am a black African obtained my training outside the country and have received further trainings here in the UK, worked on placements at several places and charities. I feel that the division should do more on integrating members from different backgrounds.

I have been an 8b psychologist for a long time and have very limited options for career development working in a small trust in a rural location and therefore feel unsure of my future in the NHS.

In 2 years since qualifying, I have seen numerous cuts to MH services, services out to tender and freezes to positions. I have noted that services are expected to see the same if not more numbers of clients with less staff



meaning increased waiting times, pressures on 'number of contacts' rather than quality of care. This has led to services taking a fire fighting approach where people will be seen for a short number of sessions with an expectation that they will be back 'in a few months' rather than focussing on a preventive, longer-term view.

My NHS role is fraught with difficulties due to transformation of services which has been threatened over many years but never seems to progress. There is constant demand for more for less and it feels unsustainable. My private work is a security blanket in the face of NHS uncertainty.

Many of us are outside the NHS now.

Alarmed at de-banding of posts and inequities in provision. There is a huge role for clinical psychologists in delivery of health and care across all sectors.

We have fewer and lower grade staff than even 5 years ago.

It's hard to measure economic impact. In general non psychologists do not really understand the profession

Few preceptorships. More fixed term posts. More demand and more part-time posts than when I started training 6 years ago. Most of my supervisors' posts on placements have been de-banded to band 7 from 8a.

There is a need for more senior Clinical Psychologists to be recognised and valued, rather than trying to down grade them. Also, huge gaps in services such as in health related areas. There needs to be more focus on the value Clinical Psychologists can bring and an invest to save outlook rather than the view that we are expensive. We can do a lot to prevent patients using and putting a strain on other services if there is investment in them working alongside medical colleagues.

I do not wish to work in an IAPT service any more. It has been a disaster for Clinical Psychology. I wish to re-train as a psychotherapist so I may work in private practice or else leave mental health work altogether.

My NHS employer did not retain my post when I retired. Saved money but downgraded the service, leaving Band 7 and 8a psychologists with inadequate support.

I am concerned that as the cost cuts for the NHS start to kick in there seems to an increasing push to see Clinical Psychologists as an expensive and unnecessary resource whose skills can be replaced by cheaper clinicians who do not have the same breadth of training or that more junior CP's can do the work of experienced CP's for cheaper. This is naive and short sighted and places the profession at risk for the future as well as having a detrimental impact on patient care. As a profession I feel we have to focus on demonstrating our value for money and offer ourselves flexibly within a multi-disciplinary health service. This may mean a move from clinical work to



management and service development for some but is appropriate given the nature and breadth of our training and skills.

Services are stretched we need more jobs and some kind of career progression. I have been same band for 10 years and all 8b positions have been downgraded. There is nowhere to go.

I am concerned that our banding will be downgraded. I am concerned that our specialist services are being cut. I am concerned that psychologists are not involved enough in commissioning decisions.

Recruitment is difficult within my geographical location. Posts sit empty for long periods (e.g. 18 months plus). This could jeopardise the role of clinical psychologists in the service (as gaps may be filled with other professions)

Have had to take role in private sector due to lack of opportunities (speciality and development) within the NHS

The standard grade for clinical psychologists in local NHS services is now Band 7. This does not adequately recompense for time in training, skills, experience or task demands. In my region Clinical Psychologist's skills are being undervalued and under-used.

I was becoming burnout out in the NHS, exploited in terms of hours worked and low pay. I was also struggling to juggle work with childcare so I left and now work solely in private practice. It's a good decision for me personally but I think a shame that talented, and previously committed, people are leaving the NHS. This wasn't part of a planned career plan.

10.30.2 Emerging areas

Working within an acute Trust - the scope for psychology is huge but resource to develop services is limited

I'm a Clinical Psychologist employed by NHS but work full time in a youth offending team as part of a service level agreement with the local authority

I work in the private sector because I could not find a job at my level of experience after returning from abroad. I love my job and find it more satisfying and less stressful than previous NHS posts. I

increasing evidence to support the value of psychologists working alongside other Health Care Professionals in physical health care settings both in terms of clinical outcomes and patient experience, I suspect that clinical health psychology will be a growth area for clinical psychologists in the future. Unfortunately training courses do not seem to reflect this area of growth adequately in terms of their teaching provision.

The good news is that clinical psychology is highly valued in this hospital and in those departments who don't yet have any input, are very keen to have some.



We need more psychologists to work with older people and we need to stress the 'spend to save' potential of integrating more with physical health and social care services

1. There is a challenge for those of us working as trainers who have to hold 2 separate contracts which are not equal in seniority. Taking together they would achieve a higher banding then either separately. 2) We need to be looking ahead to developing new roles, especially in public health and primary care re prevention and promotion of wellbeing

I plan to go part-time as soon as I can afford it/build up some private Medico legal practice.

Maintaining a Psychology Department Structure (which has professional leadership but not line management responsibility) enables us to continue to adapt as a profession to the myriad ways in which psychology can support the organization to deliver on its core business. As well as the rapidly growing evidence base in physical health (and still relatively under developed clinical health psychology services in many areas), recent opportunities have also arisen to contribute to the organizational response to Francis and Andrews, with the development of Schwartz rounds and other related initiatives.

Stroke Psychologist, completing the QiCN. Provision for more Psychology services in stroke is desperately needed.

Recruitment in my specialty of pain management has become somewhat easier over recent years. Our post establishment is likely to increase somewhat over the next 2 years.



10.30.3 Summary of key themes

Themes, in order of weight, from DCP workforce review

10.30.3.1 Lack of career progression

a. Preceptorships not used

b. Bands 7/8a career grade now, limited senior roles to apply to

c. Moving areas, going part time, moving specialty to progress

d. Not supported with CPD to progress

10.30.3.2 More for less

a. Down banding of posts

b. Same pay, expected to do more

c. Newly qualified staff doing more in role than in past

d. Non-Clinical Psychologists doing parts of clinical psychology role for less money

10.30.3.3 Need for broader working

a. Need to broaden role from just therapy e.g. consultancy, teaching, research

18.2%

13.6% 13.5%

10.8%

9.8%

8.9%

8.3%

6.9%

5.2%

4.5%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%

Lack of career progression: Stuck

on banding, no

higher jobs, nowhere to progress to.

More for less: Issue of downbanding,

being expected to

take on more responsibility

Need for broader working

Too much pressure : expected and not

enough time,

funding for CP's

Non NHS work Leadership needed in services and from

DCP/BPS

Career structure issues: Need to develop clearer

structure from undergrad through to retirement, with

more senior

representation

Physical and mental health: increased

need for more CP's

in health

Resilience issues: Need to increase our self care, self

care is at risk, well placed to look after others self care and

promote this

Uncertainty: threats of reviewing service,

temporary

contracts.A49

Key themes emerging from clinical psychologists' responses on needs and gaps in services (online survey 2015- n =1211)



b. Not enough time to use other skills e.g. research, service development

c. Split in responses as some do not want to broaden their role out of tier 4 therapy

d. Need individuals to show more leadership

10.30.3.4 Too much pressure

a. Reduced funding, reduced Clinical psychologists but waiting lists going up

b. Limiting targets

c. High risk and complexity

10.30.3.5 Non-NHS work

a. Creative work possible, can be rewarding

b. Feeling forced out of NHS due to lack of progression, the pressure etc.

c. Need more support for non-NHS Clinical psychologists from DCP/BPS

d. Trainees should be trained for this

e. Filling gap in NHS services

10.30.3.6 Leadership needed

a. DCP needs to be stronger, advocate more and challenge more

b. Clinical psychologists need more training in leadership

c. Clinical psychologists need to do more management roles

d. Leadership from Clinical psychologists in services as managers and board members

e. Want clarity on what DCP is for

f. Want DCP to be like RCP

10.30.3.7 Career structure issues

a. Loss of AP role

b. Loss of senior posts limiting supervision

c. Progression from undergraduate to consultant unclear in NHS

d. Guidelines for what each grade does



e. Neuropsychology training issues- access limited

10.30.3.8 Physical health development

a. Potential for increasing Clinical psychologists roles

b. Preventative work

10.30.3.9 Resilience issues

a. Burn out, stress and demoralised by work

b. Clinical psychologists well placed to lead to supporting others to be resilient

c. Need protected time for reflection and resilience building

10.30.3.10 Uncertainty

a. Threats of service reviews and down banding

b. Temporary or fixed term contracts

c. Future of profession in NHS unclear

10.30.4 Clinical psychologists' view of service needs and gaps (West Midlands online survey June 2014)

Table 97 Clinical Psychologists' current analysis of service needs and gaps

Themes No of mentions % total

Clinical needs unmet 115 31.0

Loss of posts 93 25.1

Downbanding 40 10.8

Re-structure/re-tender of service 26 7.0

Frozen/vacant posts 24 6.5

Not meeting standards 24 6.5

Increase in posts 18 4.9

Skills not valued 15 4.0

Supervision 8 2.2

Training 8 2.2

Total 371 100.0



Figure 171 Needs and Gaps: Clinical Psychologists' views

The Figure above indicates major concerns by survey respondents in terms of current staffing levels leaving many clinical needs unmet. Major concerns were expressed about loss, freezing and down banding of posts. A number of services were being re-structured and re-tendered leading to uncertainties for staff and future provision. Worries about not meeting required quality standards and NICE guidance were also prominent. A minority of respondents (mainly in child and physical health services) recorded a recent increase in clinical psychology posts.

Some psychologists felt their skills were not valued.

There were some difficulties in accessing adequate supervision and training.

Most frequently mentioned areas of unmet clinical need were:

Physical health

Specialist mental health

Complex case

Learning disability

CAMHS

Older adult/dementia

Neuropsychology

31.0

25.1

10.8

7.0 6.5 6.5

4.94.0

2.2 2.2

0.0

5.0

10.0

15.0

20.0

25.0

30.0

35.0

Clin

ical ne

ed

s un

me

t

Loss o

f po

sts

Do

wn

ban

din

g

Re

-structu

re/re

-ten

de

r of se

rvice

Froze

n/vacan

t po

sts

No

t me

etin

g stand

ards

Incre

ase in

po

sts

Skills no

t value

d

Sup

ervisio

n

Trainin

g

% o

f to

tal r

esp

on

ses

Themes: Clinical Psychology Workforce- June 2014



Looked after children

Forensic service

Figure 172 Areas of unmet clinical need: Online survey June 2014

10.31 Service User views

Mental health service users have consistently valued access to psychological therapies and expertise.

For instance, following an extensive consultation with people attempting to access psychological therapies, statutory and third sector mental health providers and primary care trusts, the "We need to talk coalition" (MIND, Centre for Mental Health, Rethink, Young Minds, Mental Health Foundation, St Mungos, Royal College of General Practitioners, Royal College of Psychiatrists, British Association of Counselling and Psychotherapy, British Association of Behavioural and Cognitive Psychotherapy, British Psychological Society, British Psychoanalytic Council, WPF therapy, New Savoy Partnership), report43 included the following recommendations:

People should be given a full and informed choice when accessing psychological therapies. This should include choice around therapist, therapy type, appointment times and location of treatment.

Commissioners must not use IAPT funds as an excuse to cut resource to other psychological therapy services.

Commissioners should aim to integrate all psychological therapy provision at local level.

23.5

18.5

16.0

9.98.6 8.6

7.46.2

1.2

0.0

5.0

10.0

15.0

20.0

25.0

Physical health need

Specialist mental health

Complex case need

Learning disability need

CAMHS need

Older adult/dem

entia need

Neuropsychology need

Looked after children need

Forensic service need

% o

f tot

al re

spon

ses

Areas of unmet clinical need: survey June 2014



Commissioners should commission IAPT services that have the capacity to provide people with an appropriate number of therapy sessions to achieve the best outcome for people using the service.

Commissioners should ensure that those with complex and severe mental health needs have access to suitable and specialist psychological therapies.

Commissioners should build upon the existing workforce, as well as supporting training for future practitioners, to ensure that psychological therapy services are led by senior clinicians and that different therapies are delivered by professionals of corresponding levels of competency

10.32 Areas of concern

Banding/down-banding of posts

Limited opportunities for career development

Role not understood appreciated

Workload pressures/targets/waiting lists

More responsibilities and workload for less pay/lower band than previously

Loss of senior/consultant posts

Lack of resources but "more for less" expected

Access to supervision and CPD

10.33 Areas of development

General/physical health

Psychosis/inpatient services

Personality disorder

Private/independent practice

Work for third sector/local authority

Child/CAMHS services

Neuropsychology

Forensic services

Training others/supervision

Complex case formulation

Management and leadership of services



11 WORKFORCE PLANNING: POPULATION NEEDS ANALYSIS

In this Section, some scoping of future needs for clinical psychology workforce is presented.

Some challenges for horizon scanning the workforce of the future are presented below44.

The Centre for Workforce Intelligence (CfWI) recommends a systematic approach to the assessment of workforce need. There is little or no evidence that this approach has been used in estimation of future needs for clinical psychology workforce in the UK. CfWI has published further technical guidance to improve the robustness of workforce planning45,46,47

Another CfWI paper has analysed workforce risks and opportunities for allied health professionals48, including potential reduction in education commissioning, availability of supervised clinical placements, current freezing of posts, shortage of senior and specialist staff, demand from multiple sectors, and demand from other countries. Opportunities include supporting the delivery of increasing care in the community; public health and health promotion; recovery rehabilitation and re-ablement and the development of new support and advanced practitioner roles.

The Centre for Workforce Intelligence (CFWI) advised the British Psychological Society (BPS) of the need to guide workforce modelling and provide advice to Health Education England (HEE). The HEE Strategic Plan 2013/14 set out its intent to keep national training commission numbers stable in clinical psychology yet West Midlands reduced their level by 25%.

The following key findings emerged

1. Capacity and skill mix was varied throughout UK Regions an inequitable "postcode lottery" in terms of access and spread of clinical psychology services

2. There was no clear evidence of regional or local needs assessment process for clinical psychology, linked to clinical governance/ public health/national policy/best practice guidance across all care sectors; or reducing risk such as that highlighted by National Audit of Psychological Therapies indicating unqualified therapists practicing in NHS.

3. There was an average discrepancy of 10% in the data triangulation of national statistical data and locally validated returns. There was evidence of miscoding of posts. The majority of local leaders of psychological services indicated they had not been consulted on workforce baseline, planning and projections in NHS organisations and in some contexts leadership posts had been lost so professional advice would not have been available.

4. Current workforce models are predicated on inaccurate baseline data and imprecise supply and demand assumptions.



5. A draft supply and demand model across all employment sectors is currently under development by the BPS and further collaboration with CFWI, HEE and CQC (Care Quality Commission) is anticipated.

6. A workforce model needs to be responsive to the changing demographic profiles and this project found increasing feminisation of profession (90% under 34 were female) and an increase in part-time and portfolio working between employment sectors. Many in the older cohort have MHO (Mental Health Officer) status with implications for projected retirement patterns.

7. Only 29% of clinical psychologists worked in Adult or Child NHS mental health care as their main area of work. Other significant areas of expansion were criminal justice; neuropsychology, physical/behavioural health (e.g. long term conditions. cancer care -Macmillan is supporting psycho-oncology expansion)-renal, diabetes); older adults; universities and residential care.

8. It was not possible to comprehensively map providers in social enterprise organisations, private sector, residential and educational contexts. However, 20% of clinical psychologists were working outside the NHS This demand is growing and needs to be factored into training commissions and workforce projections.



Figure 173 Workforce Planning Framework: Centre for Workforce Intelligence



Figure 174 Centre For Workforce Intelligence: Big Picture Challenges

The Health Education England Strategic Framework 2014-2029xlix acknowledges these future trends.

11.1 Population trends

A number of demographic trends will influence the need for clinical psychologists over the next decades, according to the Kings Fund analysis of future trends in UK healthcarel

Figure 175 UK Population trends 2012 to 2032

11.1.1 The population is growing

Over the next 20 years (2012-2032) the population in England is predicted to grow by 8 million to just over 61 million, 4.5 million from natural growth (births – deaths), 3.5 million from net migration.

The UK population is projected to grow by approximately 7% to 68 million between 2012 and 2022.

11.1.2 The population is becoming more diverse

By 2031, ethnic populations will make up 15 per cent of the population in England and 37 per cent of the population in London.

11.1.3 More people are living alone

By 2032 11.3 million people are expected to be living on their own, more than 40 per cent of all households. The number of people over 85 living on their own is expected to grow from 573, 000 to 1.4 million.



11.1.4 Birth rate

After recent growth, the number of births each year is expected to level off

Over time birth rates have fluctuated quite significantly. Current predictions are that the annual number of births will level off to around 680,000–730,000 births per year.

11.1.5 Life expectancy and healthy life expectancy are growing

In 1901 baby boys were expected to live for 45 years and girls for 49 years. In 2012, boys could expect to live for just over 79 years and girls to 83 years. By 2032, this is expected to increase to 83 years and 87 years respectively. Healthy life expectancy is growing at a similar rate, suggesting that the extra years of life will not necessarily be years of ill health.

11.1.6 The population is ageing

The number of people aged over 85 in the UK is projected to increase from 1.4 million to 2.4 million by 2027 and 3.6 million by 2037.

The number of people over 65 with care needs is projected to increase by 60% to 4.1 million. The average age of NHS employees in the UK is currently 44 years (in 2011, UK) and it is projected to rise to over 47 years by 2023.On average in the NHS in the UK the number of hours worked declines with age. As the workforce gets older the proportion of part time workers may increase, depending on other economic factors.

The combination of extending life expectancy and the ageing of those born in the baby boom, just after the Second World War, means that the population aged over 65 is growing at a much faster rate than those under 65. Over the next 20 years the population aged 65-84 will rise by 39 per cent and those over 85 by 106 per cent.

After a recent decline, the number of deaths each year is expected to grow

The number of deaths each year is expected to grow by 13 per cent from 462,000 to 520,000 by 2032.

11.1.7 Health inequalities persist

Men and women in the highest socio-economic class can, on average, expect to live just over seven years longer than those in the lowest socio-economic class, and more of those years will be disability free.



12 SUPPLY AND DEMAND MODELLING FOR CLINICAL PSYCHOLOGY

12.1 Centre for Workforce Intelligence: Improving workforce planning for the psychological therapies workforce

The Centre for Workforce Intelligence in their document "Improving workforce planning for the psychological therapies workforce"li noted there is inconsistent and incomplete data about the psychological therapies workforce.

There is currently no consistent single definition of what a psychological therapist is, although there is a clear desire to have a definition and to promote a shared understanding across all psychological therapy modalities.

After careful consideration of the feedback received from stakeholders, and discussion with the project advisory group, the CfWI proposes that to be defined as a psychological therapist, the following standards must be met.

Required standards for a psychological therapist:

1. To have completed one year of recognised full-time (or equivalent part-time) psychotherapy or counselling training leading to a qualification, certification or accreditation recognised by a relevant professional or regulatory body.

2. To have achieved a competency level that fulfils the requirements of the regulatory, accrediting or professional body.

3. To be a member of a relevant professional or regulatory body, and continue to fulfil any accreditation or membership criteria, including meeting requirements for continuing professional and personal development and regular supervision

4. To have gained the supervised therapy experience required by the regulatory or professional body.

12.1.1 Key findings and recommendations from CfWI

Key findings from the Centre for Workforce Intelligence reportlii include:

The number of recorded NHS clinical psychologists appears to be greater than the number of all applied psychology staff registered with the Health Professions Council (HPC). This suggests significant limitations in data and potential for misrepresentation.

The Improving Access to Psychological Therapies (IAPT) programme is set to increase the number of psychological therapists.

A risk to the workforce is that skill-mix and supply pipelines are not discernible for different groups of staff involved in IAPT.



Calls for growth in research may increase demand for the services of clinical academic psychologists in the future.

Roles including Approved Mental Health Professional and both Approved and Responsible Clinicians (Mental Capacity Act 2007, Mental Health Act 2007) have extended the activity of applied psychologists.

Commissioners to monitor skill mix occurring through the IAPT programme and consider how this may affect future commissioning

Health and Social Care Information Centre (HSCIC) and the British Psychological Society (BPS) to confirm and adopt a solution to accurately identify applied psychologists together with psychological wellbeing practitioners, high-intensity therapists and other developing roles in the NHS, in discussion with other associated professional bodies as necessary so that In-depth data can be collected on all applied psychology divisions

The Department for Health (DH) to work with the profession to devise a method for recording workforce information in the private and independent sectors because qualified staff may transfer in or out of the public sector at any point in their career

Employers to work with the CfWI, through Strategic Health Authorities (SHAs) now and in the future through the Local Education Training Boards (LETBs) to investigate levels of demand from the perspective of service providers in addition to population demand and in the context of government strategy such as IAPT.

Inaccuracies in baseline coding of posts

◦ Leads to over-estimate of number of posts as other professions coded as “psychological therapists”

Reduction in leadership posts

◦ Psychologists not having over-view Trust wide of posts and codings

◦ Poor involvement in workforce planning and associated management/service development/planning structures in some Trusts

Associated with more severe reductions in staffing

◦ Loss of “the elders”

◦ Managed by non-psychologists with poor understanding of role/contribution

Issues

Banding/down-banding of posts

Cuts/threats to existing services

Limited opportunities for career development

Role not understood/appreciated



Workload pressures/targets/waiting lists

More responsibilities and workload for less pay/lower band than previously

Lack of resources - but "more for less" expected

Limited access to supervision and CPD

Isolation/lack of support

Issues

Lack of transparency in workforce planning models e.g.

◦ Need to account for:

Part-time working

Retirement

Attrition

Movement in and out of Region

Projection of future demand: ALL sectors

Small changes in formula make a big difference to projections

FOI data state 100 fewer clinical psychologists in the West Midlands than National HSCIC workforce returns would indicate

Inaccuracies rife in UK central data

The current inaccuracies in workforce profile mean that supply and demand models build on this information will be unreliable.

It is essential that clinical psychology leads are involved and check the accuracy of their local workforce information.

Trends

Buoyant demand for clinical psychology graduates

Just under 20% of qualified clinical psychologists currently undertake some work in non-NHS settings

This trend is likely to grow – training courses need to plan for this

◦ C. 15% newly qualified found jobs in independent/third sector

◦ C. 6 advertisements per month for PIV clinical psychologists (mainly newly qualified)

Increasing self-employment/portfolio careers



12.2 Data quality: Electronic Staff Record

The ESR includes data on the staff members Trust, Occupation Code and Age.

ESR data quality is paramount but there are problems including

Miscoding of staff can cause large problems

Other incorrect details affect elements such as retirement model

12.2.1 Retirement

A detailed retirement model needs to be calculated per staff group and checked for validity against known retirements (accurate outputs). The model uses likelihood of retirement at each age to remove a percentage of workforce each year and is applied sequentially across planning period.

Retirement post-65 assumptions are difficult due to typically low numbers, though this has a limited impact due to those low numbers. Circa. 25% of retirees return to work, for an average of 2 years at about 60% of their previous full time equivalent).

12.2.2 Pay drift

Pay Drift has a huge effect on the pay bill. An average of 0.65% pay inflation per year occurs simply by staff progressing through bands. Pay awards are in addition to this (impact to be calculated for 2014/15 based on 1% uplift for those at top of band, though non-consolidation will complicate matters)

The method uses ESR Reports broken down to AfC Band and Spine point and the total pay bill is calculated.

Turnover is used to revert a percentage of staff to bottom of band (assuming that replacements start on bottom of band)

12.2.3 Non-NHS Workforce

There are gaps in relation to the clinical psychology workforce employed by Local Authorities and the Private, Independent and Voluntary sector. The supply and demand characteristics of this employment sector have not been modelled and there is a lack of alignment with NHS pay bands.

12.2.4 Supply model parameters

The current supply/demand modelling undertaken by HEE indicates some potential over-supply of psychologists from training courses in response to demand by NHS Trusts but the underpinning assumptions do not appear explicit, stable or robustly grounded. For instance, HE West Midlands in May 2014 projected an over-supply figure of 172 psychologists by 2018. This has



been revised down in August 2014 to a projected over supply of 32 psychologist by 2018. Issues such as attrition through retirement and other reasons for leaving the service were inadequately addressed.

However, recruitment figures would seem to contradict this over-supply scenario and national policy and plans would seem to anticipate an increasing need for clinical psychology skills.

This is based on NHS Trust workforce plans but there has been inadequate scoping of future demand (from non-mental health services, private/independent and third/voluntary sector) in the UK and in accordance with national health and care policy directives.

12.3 TRAINING COMMISSIONS FOR CLINICAL PSYCHOLOGY

There is little evidence of systematic analysis of population needs and links to training commissions.

12.3.1 UK Training Places for Clinical Psychology per head of population

Table 98 UK Training places for Clinical Psychology per head of population

12.4 DCP Workforce Model (Draft)

In this Section, a draft workforce model for clinical psychology is presented and can be used as a basis for modelling current and future clinical psychology workforce requirements. It will be important to test the model for its robustness in scaling future supply and demand for clinical psychologists.

12.4.1 Data accuracy and collection methods

There is a need to achieve more accurate occupational coding and staff profiling as a basis for forecasting and modelling future demand for clinical psychologists.

Region Training Places Population

Training places/1000

of population

% of UK average

training places per

head of population

South Central 15 4025400 0.0037 36.7

East Midlands 30 4500000 0.0067 65.6

East of England 40 5847000 0.0068 67.3

West Midlands 2014 42 5600000 0.0075 73.8

North Eeast 62 7897000 0.0079 77.2

Wales 25 3060000 0.0082 80.4

Scotland 51 5295000 0.0096 94.7

West Midlands 2013 55 5600000 0.0098 96.6

UK AVERAGE 594 58429000 0.0102 100.0

North West 73 6900000 0.0106 104.1

South West 58 5430000 0.0107 105.1

South East coast 62 4500000 0.0138 135.5

London 123 8300000 0.0148 145.8

Northern Ireland 11 1840000 0.0059 58.0



12.4.2 Vacancy

The NHSCIC (2010) three-month vacancy rate as at March 2010 for clinical psychologists in England was 1.1per cent.

12.4.3 Staff movement

A number of parameters need to be considered in relation to staff entering and leaving the service.

Table 99 HSCIC Reasons for Leaving and Staff Movements

If this trend also applies to clinical psychologists one might expect 15-16% of people to move jobs or leave NHS employment per annum, of which the majority (c. 3% would be retirees). This would equate to a "churn" of around 1785 people, many of whom may leave their employer to work elsewhere in the NHS or beyond and/or who may achieve promotion, vacating their existing post. Others may seek opportunities in the private, independent or voluntary sector. It is difficult to obtain accurate information on this.

Leavers from the NHSReason for Leaving Percentage of Leavers

Voluntary Resignation - Other/Not Known 19.0%

Voluntary Resignation - Relocation 14.3%

Retirement Age 14.3%

Voluntary Resignation - Work Life Balance 9.6%

Employee Transfer 8.8%

Voluntary Resignation - Promotion 5.4%

End of Fixed Term Contract 3.8%

Voluntary Resignation - Better Reward Package 3.2%

Voluntary Resignation - Child Dependants 2.2%

Redundancy - Compulsory 1.9%

Voluntary Resignation - Lack of Opportunities 1.9%

Voluntary Early Retirement - with Actuarial Reduction 1.8%

Voluntary Resignation - To undertake further education or training 1.7%

Voluntary Resignation - Health 1.6%

Voluntary Early Retirement - no Actuarial Reduction 1.2%

Dismissal - Capability 1.1%

Retirement - Ill Health 1.0%

End of Fixed Term Contract - Completion of Training Scheme 0.8%

End of Fixed Term Contract - End of Work Requirement 0.7%

Voluntary Resignation - Incompatible Working Relationships 0.7%

Mutually Agreed Resignation - Local Scheme with Repayment 0.6%

Death in Service 0.6%

Dismissal - Conduct 0.5%

End of Fixed Term Contract - Other 0.5%

Dismissal - Some Other Substantial Reason 0.5%

Flexi Retirement 0.5%

Redundancy - Voluntary 0.4%

Voluntary Resignation - Adult Dependants 0.4%

Mutually Agreed Resignation - National Scheme with Repayment 0.3%

Mutually Agreed Resignation - Local Scheme without Repayment 0.2%

Pregnancy 0.1%

Has Not Worked 0.1%

Dismissal - Statutory Reason 0.0%

Merged Organisation - Duplicate Record 0.0%

Bank Staff not fulfilled minimum work requirement 0.0%

End of Fixed Term Contract - External Rotation 0.0%

Initial Pension Ended 0.0%

Not Set in Legacy at Migration 0.0%

(blank) 0.0%

Grand Total 100.0%



An estimate is needed of the numbers of psychologists eligible for retirement (some of whom have Mental Health Officer status, enabling them to retire on a full pension at 55 years of age.

Figure 176 Estimate of staff movement in relation to clinical psychology posts

12.4.4 Draft Workforce Planning Model

The Model under development is in draft and the following Tables and Figures contain demonstration data only.

12.4.4.1 Assumptions

Table 100 Assumptions of DCP Workforce Model (demonstration data)

This Table lists the assumptions underpinning the DCP workforce model, based on "best estimates" and objective data where available. There is a need to refine these assumptions.

-11

24

-33

73

-52-58

62

-80

-60

-40

-20

0

20

40

60

80

Total retired Planned increase Planned decrease

New starters Attrition Deleted posts Vacancies

Estimate of movement of clinical psychology posts: West Midlands 2012-2014)

Assumptions

Course output 630 Per annum

Net migration (est.) 0 Per annum

Wastage (1) 2.52 Per annum

Retirement (est. 3% p.a.) 407 Per annum

Attrition (2) - est. 3% p.a. 339 Per annum

Avg % full time worked (3) 80%

Effective % of working life worked (4) 80%

1 Number failing the course or completing course but not taking up professional post with 3 years

2 Number leaving profession prior to retirement for whatever reason (including move to general management roles)/change of career

3 Average percentage of full time worked (based on survey and other NHS reports)

4 Estimated proportion of potential working life actually worked (i.e. as a result of parental leave, sabbaticals etc.)



12.4.4.2 Baseline estimates of clinical psychology workforce demand

Table 101 Baseline estimates of clinical psychology workforce demand (demonstration data only)

The baseline estimate of clinical psychology headcount data is linked to the total number of practising clinical psychologists in the UK on the HCPC register. The f.t.e. is estimated from the conversion assumption (78% or 0.78 f.t.e worked per headcount psychologist).

12.4.4.3 Planned percentage changes in workforce

Table 102 Planned percentage changes in workforce by specialties (demonstration data only)

Demand Estimates Headcount (HC)

2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

addiction 151 151 151 151 151 151 151 151 151 151 151

adult IAPT 160 160 161 163 164 166 168 169 171 173 175

adult mental health 2167 2167 2188 2210 2232 2255 2277 2300 2323 2346 2370

child and family 1549 1549 1557 1560 1568 1576 1592 1607 1624 1640 1656clinical health psychology 954 963 983 1002 1022 1043 1064 1085 1107 1118 1129

commissioning 15 15 15 16 16 16 17 17 17 17 17

consultancy 233 233 235 237 240 242 244 247 249 252 254

eating disorders 179 179 179 179 179 179 179 179 179 179 179

forensic services 587 587 587 587 587 587 587 587 587 587 587

HIV/sexual health services 67 67 68 69 69 70 71 71 72 73 73

learning disability 1107 1107 1118 1129 1140 1152 1163 1175 1186 1198 1210

management 416 416 418 419 421 423 427 431 436 440 444

neuropsychology 1003 1013 1023 1033 1043 1054 1064 1075 1086 1097 1108

older adults 634 634 640 653 666 679 686 693 700 707 714

paediatrics 527 527 527 527 527 527 532 538 543 548 554

perinatal services 96 96 96 96 96 96 96 96 96 96 96

primary care 126 126 127 130 132 135 136 137 139 140 142



emerging areas 373 373 373 373 373 373 373 373 373 373 373

Totals 11305 11324 11409 11496 11590 11686 11796 11907 12019 12122 12225

Planned changes +/- % 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

addiction 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

adult IAPT 0.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00%

adult mental health 0.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00%

child and family 0.00% 0.50% 0.20% 0.50% 0.50% 1.00% 1.00% 1.00% 1.00% 1.00%

clinical health psychology 1.00% 2.00% 2.00% 2.00% 2.00% 2.00% 2.00% 2.00% 1.00% 1.00%

commissioning 0.00% 1.00% 2.00% 2.00% 2.00% 1.00% 1.00% 1.00% 1.00% 1.00%

consultancy 0.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00%

eating disorders 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

forensic services 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

HIV/sexual health services 0.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00%

learning disability 0.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00%

management 0.00% 0.50% 0.20% 0.50% 0.50% 1.00% 1.00% 1.00% 1.00% 1.00%

neuropsychology 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00% 1.00%

older adults 0.00% 1.00% 2.00% 2.00% 2.00% 1.00% 1.00% 1.00% 1.00% 1.00%

paediatrics 0.00% 0.00% 0.00% 0.00% 0.00% 1.00% 1.00% 1.00% 1.00% 1.00%

perinatal services 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

primary care 0.00% 1.00% 2.00% 2.00% 2.00% 1.00% 1.00% 1.00% 1.00% 1.00%

teaching/training others 0.00% 0.00% 0.00% 0.00% 0.00% 1.00% 1.00% 1.00% 1.00% 1.00%

university/higher education 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

emerging areas 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%



The planned percentage increase/decrease in clinical psychology workforce for mental health trusts is based estimated projected percentages. The green spreadsheet cells can be amended for NHS and other employers as more accurate data becomes available.

Figure 177 Demonstration output: Supply and Demand

Table 103 Demonstration output: Supply and Demand & Training Surplus/Deficit

The above Figure and Table indicates how available workforce and demand can be scoped. It should be emphasised that the Table contains demonstration data only and small variations in percentage increase/decrease in workforce projections can have a major impact on the model.

Further work is needed to populate the model with more accurate supply and demand assumptions, backed by objective data wherever possible.

2000

0

2000

4000

6000

8000

10000

12000

14000

2014 2015 2016 2017 2018 2019 2020 2021 2022 2023

Training Surplus/Deficit

Available Workforce

Total Demand

Year 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023

Available Workforce 11229 11249 11333 11420 11514 11610 11720 11831 11943 12046

Total Demand 11324 11409 11496 11590 11686 11796 11907 12019 12122 12225

Training Surplus/Deficit 95 160 163 170 171 186 187 188 179 180



13 ACKNOWLEDGEMENTS

I would like to thank the many people who have assisted with this project by providing helpful background material and commenting on drafts. Particular thanks are due to the project team and project leads:

Dr Richard Pemberton, National Chair, Division of Clinical Psychology

Dr Esther Cohen-Tovee

All the clinical psychologists who completed the survey, were involved in checking the accuracy of local workforce data and contributed their views - too numerous to mention!

14 GLOSSARY OF TERMS

ACO Accountable Care Organisations

AfC Agenda for Change Pay Band

AQP Any Qualified Provider

BPS British Psychological Society

CQC Care Quality Commission

CPD Continuing Professional Development

DCP Division of Clinical Psychology

DH Department of Health

ESR Electronic Staff Record

FOI Freedom of Information

F.T.E. Full Time Equivalent

HC Headcount

HCPC Health and Care Professions Council

HEE Health Education England

HEWM Health Education West Midlands

HSCIC Health and Social Care Information Centre

IAPT Improving Access to Psychological Therapies

LA Local Authority

LETB Local Education and Training Board



LETC Local Education and Training Council

NHS National Health Services

NHSE NHS England

PHE Public Health England

QiCN Qualification in Clinical Neuropsychology

WM West Midlands



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